Approximal Tooth Surfaces Research Articles

Efficacy of Asepta Fresh liquid products by Werteks Ltd in daily oral hygiene: insights from clinical studies

Relevance. Properly selected personal oral hygiene products play a crucial role in minimizing the risk of hard tissue and periodontal diseases while also preventing their development. Consequently, there is a need for research to assess the effectiveness of various oral hygiene products and their combinations.The objective of our study was to compare the clinical efficacy of a mouthwash and an irrigant in patients with fixed or removable orthodontic appliances.Materials and methods. The study comprised 60 patients aged 20 to 29, all without medical conditions. Participants were evenly divided into two groups, each consisting of 30 individuals. The first group utilized Asepta Fresh mouthwash (Werteks Ltd, Russian Federation), while the second group used both a mouthwash and irrigant from the this brand.Results. The study observed quantitative changes in the following indices: Lange’s API, Silness – Loe, Green – Vermillion (OHI-S), and Ulitovsky – Orekhova’s HI ORTHO (Hygiene Index ORTHOdontic). Throughout the study, based on the alterations in these indices, both groups showed an improvement in oral hygiene. However, it is noteworthy that the positive trends were more pronounced in the second group.Conclusion. The use of liquid products such as Asepta Fresh (Werteks Ltd, Russian Federation) in personal oral hygiene practices proves to be a sufficiently effective method for cleaning approximal tooth surfaces. This effectiveness is substantiated by the positive changes observed in oral hygiene measured by the aforementioned indices. Hence, it may be recommended as an auxiliary method for controlling oral hygiene in orthodontics with fixed appliances.

Estimation of Alveolar Bone Loss in Periodontitis Using Machine Learning

AimThe objective of this research was to perform a pilot study to develop an automatic analysis of periapical radiographs from patients with and without periodontitis for the percentage alveolar bone loss (ABL) on the approximal surfaces of teeth using a supervised machine learning model, that is, convolutional neural networks (CNN). Material and methodsA total of 1546 approximal sites from 54 participants on mandibular periapical radiographs were manually annotated (MA) for a training set (n = 1308 sites), a validation set (n = 98 sites), and a test set (n = 140 sites). The training and validation sets were used for the development of a CNN algorithm. The algorithm recognised the cemento-enamel junction, the most apical extent of the alveolar crest, the apex, and the surrounding alveolar bone. ResultsFor the total of 140 images in the test set, the CNN scored a mean of 23.1 ± 11.8 %ABL, whilst the corresponding value for MA was 27.8 ± 13.8 %ABL. The intraclass correlation (ICC) was 0.601 (P < .001), indicating moderate reliability. Further subanalyses for various tooth types and various bone loss patterns showed that ICCs remained significant, although the algorithm performed with excellent reliability for %ABL on nonmolar teeth (incisors, canines, premolars; ICC = 0.763). ConclusionsA CNN trained algorithm on radiographic images showed a diagnostic performance with moderate to good reliability to detect and quantify %ABL in periapical radiographs.

Clinical Analysis of the Diagnostic Accuracy and Time of Execution of a Transillumination Caries Detection Method Compared to Bitewing Radiographs.

Purposes: this clinical study evaluated the accuracy and execution time of a digital imaging fiber-optic transillumination (DIFOTI) technique for the detection of approximal caries in posterior teeth compared to intra-oral examination associated with bitewing radiographs. Methods: one hundred patients were selected and submitted to clinical inspection and bitewing radiographs. The outcomes of this process were converted into scores, according to the International Caries Detection and Assessment System (ICDAS): 0—sound tooth; 1, 2, and 3—carious lesion confined within enamel; 4, 5, and 6—dentin carious lesion. Subsequently, an independent investigator acquired digital images of the same teeth using a DIFOTI device (DIAGNOcam, Kavo Dental), which were also converted into ICDAS scores. The time required for executing diagnostic procedures was measured. The clinical sensitivity and specificity of DIFOTI were analyzed by receiver operating characteristic (ROC) curves. The time necessary to perform the diagnostic methods was evaluated by Mann–Whitney U (alfa = 0.05). Results: the overall test accuracy for the DIFOTI-based device ranged from 0.717 to 0.815 (area under the ROC curve) with p < 0.0001 for all ICDAS scores. Bitewing radiographs took almost twice the time required by DIFOTI (p < 0.001). Conclusions: the DIFOTI-based device DIAGNOcam provided accurate detection of approximal caries in posterior teeth, even at early stages. The technique employed for transillumination caries diagnosis by the same device took less time than conventional bitewing radiographs. Clinical Relevance: transillumination devices, such as DIAGNOcam, can be accurately used for caries diagnosis in approximal surfaces of posterior teeth, demanding less clinical time and without radiation-related risks.

COMPARATIVE EVALUATION OF IATROGENIC DAMAGE IN CLASS II CAVITIES USING MAGNIFICATION TOOLS DURING TOOTH PREPARATION: AN IN VITRO STUDY

Aims: This is an vitro study compares and evaluates the effect of magnification tools on frequency and extent of iatrogenic damage to approximal tooth surface during conservative Class II cavity preparations. Methods and Material: 30 Typodont teeth were divided into 3 groups 10 typodont teeth in each group and were mounted on Phantom head. Teeth were prepared for class II (MO) cavity on 36 with conservative design using airotor with naked eye, loupes and microscope and iatrogenic damage was assessed on tooth no 35. Assessment of iatrogenic damage of all the groups was done by profilometer test. Statistical analysis used:Statistical analysis was done using one-way analysis of variance (ANOVA). Post-hoc pair-wise comparisons were done using Dunnetts test. Results: Results revealed that tooth preparation was better under microscopes and loupes with statistical significant difference for samples with loupes and microscope on comparison with naked eye. Study also expressed the difficulty faced during tooth preparation with microscope and loupes for the first time. Conclusions: Magnifying tools helps in better vision and less iatrogenic damage while preparing the tooth for restoration.

Dental Caries and Risk Factors in Swedish Adolescents about to Start Orthodontic Treatment with Fixed Appliances

The aim of this study is to investigate the caries situation in a group of Swedish adolescents, who were scheduled for orthodontic treatment with fixed appliances. An age- and gender-matched control group was selected from the same city (Malmö, Sweden). Caries and fillings on smooth surfaces and fillings on occlusal surfaces were diagnosed clinically and caries and fillings on approximal surfaces by bitewings. Numbers of mutans streptococci (MS) and lactobacilli (LB) were analyzed in saliva. There were no significant differences regarding manifest caries lesions and fillings on smooth surfaces. Numbers of occlusal-filled surfaces (FS) and approximal decayed and filled surfaces were around 10%, but did not differ between the groups. However, 53% had approximal enamel caries lesions in the test group and 46% in the control group. The prevalence of approximal decayed surfaces (DS) and FS was low in both groups, 0.57 ± 1.41 in the test group and 0.65 ± 1.38 in the control group (p > 0.05), i.e., somewhat more DS in the control group (p < 0.05). Most individuals had low/medium counts of cariogenic bacteria in their saliva and less than 10% high counts in both groups. Most Swedish adolescents who have been scheduled for treatment with fixed appliances appear to have a low-to-medium caries risk nowadays. However, around 10% of all approximal tooth surfaces of premolars/molars had enamel caries and one-third of the individuals had medium/high counts of cariogenic bacteria in their saliva, which may be risk factors for future caries during orthodontic treatment. Bitewing radiographs are important before starting orthodontic treatment and approximal caries and many cariogenic bacteria may be risk factors for orthodontic treatment.

Deciduous dentition approximal caries lesion progression and regression following preventive treatment: literature review.

The objective of this review was to investigate rates of caries lesion progression, arrest, and regression in approximal surfaces of deciduous teeth following secondary preventive interventions in order to inform caries management protocols. Studies published in English and other languages from 1960 till February 2017 were searched in electronic databases. Inclusion criteria were: randomized controlled clinical trials and longitudinal studies that involved non-invasive preventive treatment. We excluded: in vivo studies and incidence studies. 805 potential articles were located, of 38 full text reviews, 10 were included. Two types of studies were found; those reporting the mean percentage of lesion progression as progression estimate and those reporting the survival rate of lesions presented as the mean or median survival time in months as survival estimate. Weak evidence suggests it would appear that the most effective secondary preventive intervention was one involving a combination of silver fluoride and stannous fluoride, but this has not been substantiated. To inform treatment protocols better, it is recommended (i) that new well-designed RCTs are conducted to test the effectiveness of different forms of fluoride to arrest lesion progression in deciduous teeth and (ii) to continue ongoing research into the caries preventive effects of approximal surface sealants.

Retention of Approximal Guiding Plane Surfaces in Removable Partial Skeletal Prosthesis

BACKGROUND:The morphology of the retention tooth often does not correspond with the required design; hence there is often an indication for enamel recontouring or other restorative procedures.AIM:The study aimed to determine the impact of changing the path of insertion of the prosthesis by reshaping the anatomical and morphological structures of the natural teeth predetermined for the retention of the prosthesis.MATERIAL AND METHODS:The group of 40 patients with Class II, Subclass 1 according to Kennedy was formed, and 120 approximal surfaces of retention teeth were obtained. Two different types of prostheses were made on the models: one group in the zero point position of the model, and another group in the zero position of the model, with changing of the direction of input at an angle of 2°.RESULTS:The difference between the established and theoretical normal distribution of frequencies was tested with the Kolmogorov-Smirnov and Lilliefors tests (r < 0.10; r < 0.01). The first group showed a retention force of 0.08 N. In the second group the retention force was 0.94 N.CONCLUSION:It could be concluded that the change in the path of insertion of the dental prosthesis with conservative restorations as composite inlays, as well as the accurate extension of the prosthesis onto guiding plane surfaces, will undoubtedly increase the retention force of the prosthesis.

Evaluation of Diagnodent Accuracy in Detecting Approximal Caries in Primary Molars

Introduction: Detection of caries lesions on approximal surfaces of posterior teeth is difficult, since wide contact points hamper direct visual inspection. Due to the importance of the early detection of dental caries, the aim of this study is to compare the performance of different methods (visual, bitewing radiography and DIAGNOdent) in detecting approximal caries in primary molars. Methods: Thirty six children were selected from patients referred to the pediatric dentistry department of Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Two examiners evaluated 229 approximal surfaces of primary molars using: visual inspection, radiography and a pen-type laser fluorescence device (DIAGNOdent) for the presence of proximal caries. The surfaces were evaluated by 2 other examiners for the presence of white spots or cavitations. Sensitivity, specificity and accuracy (percentage of correct diagnosis) were calculated for each method. The area under the receiver-operating characteristics curve (A z) was calculated for DIAGNOdent device. The inter-examiner reproducibility was calculated using the intra-class correlation coefficient (ICC values) for laser Fluorescence and agreement coefficient for visual and radiographic methods.Results: At white-spot threshold, a DIAGNOdent device presented better performance. At cavitation threshold the radiographic method demonstrated higher sensitivity than visual inspection and DIAGNOdent device .In this threshold, all methods presented high specificities Conclusions: A DIAGNOdent device performs better in white spot threshold. However, radiography shows better performance in detecting more advanced approximal caries lesions.

The diagnostic accuracy of a laser fluorescence device and digital radiography in detecting approximal caries lesions in posterior permanent teeth: an in vivo study

The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18–37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P < 0.001). The optimal cut-off values for detecting approximal caries lesions in posterior permanent teeth were >16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen’s diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth.

Detection of Caries Around Amalgam Restorations on Approximal Surfaces.

To evaluate the in vitro performance of the International Caries Detection and Assessment System (ICDAS) visual examination, bitewing radiography (BW), and the DIAGNOdent 2190, a pen-type laser fluorescence device (LFpen), in detecting caries around amalgam restorations on approximal surfaces. Approximal surfaces (N=136) of permanent posterior teeth (N=110) with Class II amalgam restorations were assessed twice by two experienced examiners using ICDAS, BW, and LFpen. The occurrence of proximal overhangs was also evaluated. The teeth were histologically prepared and assessed for caries extension. Different cutoff limits for the LFpen were used. Intraexaminer and interexaminer reproducibility showed moderate to good agreement for all the methods (weighted κ/intraclass correlation coefficient=0.40 to 0.87). The specificities at D1 (all visible lesions affecting enamel) and D3 (lesions extended into dentin) were, respectively, 0.41 and 0.82 for ICDAS, 0.70 and 0.82 for BW, and 0.77-0.89 and 0.88-0.94 for LFpen. The sensitivities were 0.80 and 0.52 for ICDAS, 0.56 and 0.51 for BW, and 0.04-0.23 and 0.01-0.02 for LFpen at D1 and D3, respectively. At the D1/D3 thresholds, the accuracy and the area under the receiver operating characteristic curve (Az) values were similar and statistically higher for ICDAS (0.65/0.68 and 0.633/0.688) and BW (0.64/0.68 and 0.655/0.719), respectively; whereas, LFpen presented lower accuracy (0.37-0.44/0.49-0.52) and Az (0.390-0.454/0.345-0.395) values. The occurrence of overhangs (26.8%) was shown to be irrelevant in determining the presence of secondary caries. The ICDAS and BW methods presented the best performance in detecting caries lesions affecting enamel and dentin on approximal surfaces of amalgam restorations.

Caries in adolescence – influence from early childhood

To analyse the relationship between caries determinants in early childhood and caries prevalence in proximal surfaces in adolescents at the age of 15 years. The present longitudinal study is part of a series of surveys of oral health in 671 children followed from 1 to 15 years of age. Data were selected from examinations, interviews and questionnaires at 1, 3 and 6 years and bitewing radiographs at 15 years of age. Uni- and multivariable logistic regression analyses were performed to identify caries-related determinants. The outcome variable was carious lesions and fillings (DFa) in approximal tooth surfaces at 15 years of age. Statistical comparisons were made between caries-free teenagers, DFa = 0 and teenagers with DFa > 0, DFa ≥ 4 and DFa ≥ 8, respectively. In the final logistic regression analyses, caries experience at 6 years and mother's self-estimation of her oral health care as being less good to poor remained statistically significant and were related to caries in all three caries groups (i.e. DF > 0, ≥4 and ≥8) at 15 years of age. The consumption of sweets at 1 year remained statistically significant, with a caries experience of DF ≥ 4 and ≥ 8. The variables 'parents born abroad' and female gender were statistically significantly associated with DFa ≥ 4 and DFa ≥ 8, respectively. Furthermore, infrequent toothbrushing habits at 3 years of age and failure to attend the examination at 1 year were statistically significantly associated with caries at 15 years in the univariable analyses. Early caries experience, consumption of sweets at an early age and mother's self-estimation of her oral health care as being less good to poor are associated with approximal caries in adolescents. The study indicates that caries determinants identified during early childhood have a strong impact on approximal caries in adolescence.

In vitrocomparison of digital and conventional bitewing radiographs for the detection of approximal caries in primary teeth exposed and viewed by a new wireless handheld unit

The aim of this study was to compare the diagnostic quality of a new wireless handheld unit (ADX4000; Dexcowin Co. Ltd, Korea) on conventional bitewings and its LCD screen for the detection of approximal caries in primary teeth. In total, 108 approximal surfaces of primary teeth were examined in vitro by 3 observers. Conventional films were viewed under subdued lighting conditions on a conventional view box. Digital 3.5 inch images were displayed on the built-in monitor of the ADX4000 and digital 17 inch images were viewed on a 17 inch monitor. The true caries diagnosis was based on histological assessment of the approximal surfaces after sectioning the primary teeth. Receiver operating characteristic (ROC) curve (A(z)) analysis was used to assess the diagnostic quality of imaging modalities. The areas under the ROC curves ranged from 0.786 (digital 17 inch) to 0.813 (digital 3.5 inch). No statistically significant differences were found between the three modalities for detecting approximal caries. It was concluded that the diagnostic quality of conventional film and digital images, which were exposed and viewed by a new wireless handheld unit, was comparable.

Effect of monitor display on detection of approximal caries lesions in digital radiographs

The aim was to compare the accuracy of five flat panel monitors for detection of approximal caries lesions. Five flat panel monitors, Mermaid Ventura (15 inch, colour flat panel, 1024 x 768, 32 bit, analogue), Olórin VistaLine (19 inch, colour, 1280 x 1024, 32 bit, digital), Samsung SyncMaster 203B (20 inch, colour, 1024 x 768, 32 bit, analogue), Totoku ME251i (21 inch, greyscale, 1400 x 1024, 32 bit, digital) and Eizo FlexScan MX190 (19 inch, colour, 1280 x 1024, 32 bit, digital), were assessed. 160 approximal surfaces of human teeth were examined with a storage phosphor plate system (Digora FMX, Soredex) and assessed by seven observers for the presence of caries lesions. Microscopy of the teeth served as validation for the presence/absence of a lesion. The sensitivities varied between observers (range 7-25%) but the variation between the monitors was not large. The Samsung monitor obtained a significantly higher sensitivity than the Mermaid and Olórin monitors (P<0.02) and a lower specificity than the Eizo and Totoku monitors (P<0.05). There were no significant differences between any other monitors. The percentage of correct scores was highest for the Eizo monitor and significantly higher than for the Mermaid and Olórin monitors (P<0.03). There was no clear relationship between the diagnostic accuracy and the resolution or price of the monitor. The Eizo monitor was associated with the overall highest percentage of correct scores. The standard analogue flat panel monitor, Samsung, had higher sensitivity and lower specificity than some of the other monitors, but did not differ in overall accuracy for detection of carious lesions.

The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters

The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation. The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions. Seventy students (mean age 14 years) with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation. The results showed that the incorporation of FOTI and radiographic examination represented an additional diagnostic yield of 50% and about 110%, respectively, compared to clinical examination alone. We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions. Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

Interdisciplinary approach for the treatment of periodontally compromised malpositioned anterior teeth: a case report

Today many adult patients with periodontal disease demonstrate positioning of teeth that comprise their ability for proper mechanical tooth cleaning of approximal tooth surfaces. With adequate combined periodontal-orthodontic treatment it is possible to re-establish a healthy and well-functioning dentition. However, while orthodontic treatment can realign periodontally affected teeth, esthetic appearance may be compromised by gingival recession due to alveolar bone dehiscences or fenestrations in combination with a thin gingival biotype. This article reports an interdisciplinary (periodontic, orthodontic, restorative) approach for the treatment of a periodontally compromised patient with anterior dental malalignment. Periodontal therapy, including periodontal plastic surgery to obtain root coverage as well as orthodontic treatment by means of a miniscrew implant anchorage were used to achieve stable periodontal conditions and successful esthetic and functional final results.

Tooth pathology analysis of osteological material from the medieval locality of Saint Pantelejmon church in Nis

Medieval necropolis at the porch of St. Panteleimon church in Nis, from 12th century represents a typical Serbian necropolis, which has its analogies in several areas in Serbia. Preservation of the skeletal remains belongs to category of good and medium preservation. The aim of the work was to study the skeletal remains for the prevalence of tooth caries, localization of caries lesions, presence of abrasion, supragingival tartar and resorption of alveolar bone as the indicator of periodontal disease. The analyses included 42 skeletal remains. The anthropological analyses involved paleopathological findings on 954 teeth of 22 men and 20 women. The pathological changes of teeth were determined by inspection, dental probe, dental mirror and x-ray examination. Epidemiological research was done using average caries index. The antropological tooth pathology research of osteological material from the medieval localization of St. Pantaleimon Church in Nis showed the presence of caries in 7.86% cases, 9.93% women and 6.07% men. In 76% caries were localized on the approximal surfaces of teeth. Abrasion of the second and third degree was registered on the side and front teeth with transformation of contact points into contact surfaces and the creation of approximal, interstitial, scolded surfaces. A large quantity of supragingival tartar was found in all individuals aged over 25 years. Expressed alveolar bone resorption is the indicator of generalized periodontal disease. The prevalence of caries in the studied medieval population from the 12th century was sporadic, with localization on secondary predilection places. The abrasion of the second and third degree was present, and the resorption of the alveolar bone was registered in all the examined skeletal remains, which was the indicator of spread periodontal disease in this period.

Grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth

This study investigated grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth. 51 children (4-10 years old), presenting with radiolucency in the outer half of the dentin on the approximal surfaces of deciduous molar teeth and approximal anatomic contact with the adjacent tooth (without restoration or cavitated caries lesion), participated in the study. Bitewing radiographs were made, and temporary tooth separation was performed and an impression taken to detect cavitation. Radiographs were scanned (300 dpi) and grey levels were measured in carious and sound dentin. Impressions were also scanned and the size of cavity opening was measured in square millimetres. Grey levels of carious dentin (115.27+/-33.52) were significantly lower compared with sound dentin (151.88+/-30.99). No significant differences were observed in the dentin degree of radiolucency between "cavitated" and "non-cavitated" carious dentin. Cavitated lesions showed deeper radiolucent lesions compared with non-cavitated ones (P=0.03). There was no association between the size of cavitation and radiolucent lesion depth. Grey levels did not indicate cavitation in the outer half of the approximal dentin lesions. However, extension of a radiolucent lesion deep into the outer half of the dentin was associated with cavitated lesions independently of the size of cavitation. A computer-aided image analysis may help clinicians in monitoring caries progression and evaluating the probability of occurrence of cavitated caries lesions.

Bond strength of two total‐etching bonding systems on caries‐affected and sound primary teeth dentin

As bond strength of currently available adhesive systems in caries-affected teeth dentin on primary tooth dentin was not well known, the bond strength of two bonding systems (PQI and OptiBond Solo Plus) was evaluated on caries-affected and sound primary molar tooth dentin and observed the micromorphology of the adhesive-dentin interfaces. By grinding both the sound (n = 30) and caries-affected (n = 30) approximal surfaces of teeth, flat dentin surfaces were obtained. The prepared surfaces were bonded with one of the each adhesive systems and a composite resin. After storing the bonded specimens in water at 37 degrees C for 24 h, the samples were sectioned and the bond strength of the adhesive systems was tested by the microshear test method. The data were statistically analysed. Microshear bond strengths of PQI group for caries-affected and sound primary tooth dentin were 9.43 +/- 2.44 (MPa) and 9.32 +/- 2.95 (MPa) (P > 0.05), respectively, and the bond strengths of OptiBond Solo Plus group for caries-affected and sound primary tooth dentin were 15.33 +/- 3.59 (MPa) and 11.96 +/- 2.30 (MPa) (P < 0.05), respectively. Micromorphological features between sound and caries-affected dentin were similar in both PQI and OptiBond Solo Plus groups. Both the adhesives showed significantly different bond strengths in caries-affected dentin but showed similar bond strengths in sound dentin.

Prevalence of Approximal Caries in Posterior Teeth in 15-Year-Old Swedish Teenagers in Relation to Their Caries Experience at 3 Years of Age

The aim of the present investigation was to study the prevalence of approximal caries lesions and fillings in posterior teeth at 15 years of age in a prospectively followed Swedish population (n = 568), with special reference to their caries experience at the age of 3 years. Only approximal surfaces were recorded, since all children in the Community of Jönköping have had fissure sealing performed on all caries-free permanent molars. At 15 years of age, the mean number of approximal tooth surfaces with initial caries lesions (D_ia), manifest caries lesions and fillings (D_mFa) and total caries experience and fillings (D_{i + m}Fa) – recorded on bitewing radiographs – was 2.78 , 0.45 and 3.23, respectively. One third of the adolescents had no approximal caries or fillings; the D_ia constituted 86% of the D_{i + m}Fa. Children with manifest caries at 3 years of age had a higher risk of developing approximal caries in their permanent teeth than caries-free children at the same age (41 vs. 17%). Furthermore, children who were caries-free at 3 years of age were more likely to remain caries-free at 15 years of age compared to children with manifest caries (37 vs. 17%). All these differences were statistically significant (p < 0.001). Additionally, early childhood caries experience (developed before 3 years of age) had a greater predictive value than late childhood caries experience (developed between 3 and 6 years of age) concerning approximal caries at 15 years of age.

Risk Factors for a False Positive Test Outcome in Diagnosis of Caries in Approximal Surfaces: Impact of Radiographic Modality and Observer Characteristics

The aim of this study was to evaluate the impact of image modality and observer characteristics on radiographic caries diagnosis with particular emphasis on the false positive (FP) test outcome. Eighty human teeth were radiographed by eight digital modalities and film. Eight observers scored caries lesions in each approximal tooth surface. Their use of image enhancement and time spent in assessing an image was recorded. Microscopy served as validation for the presence/absence of a lesion. Of 160 approximal surfaces, 63% were sound and 37% had lesions. Multivariate logistic regression analysis was performed with the FP test outcome as the dependent variable and the radiographic modality and observer’s gender, experience, employment, image enhancement, and time use as the independent variables. The significant risk factors for an FP test outcome were: (1) gender: males scored fewer FP than females (OR 0.26, CI 0.18–0.36); (2) experience: observers with no experience with digital radiography had a six times higher risk for an FP (OR 6.09, CI 4.9–8.1); (3) radiographic modality: two of the digital systems had a significantly lower risk for an FP [a phosphor plate system (OR 0.55, CI 0.37–0.73) and a sensor-based system (OR 0.65, CI 0.46–0.93)] and one phosphor plate system had a higher risk (OR 1.57, CI 1.17–2.13) than film; (4) time use: more time was spent when scoring an FP (OR 1.05, CI 1.03–1.05) than for any other test outcome. Type of employment and the use of image enhancement had no significant impact on the risk for an FP diagnosis.