Detection Of Caries In Primary Teeth Research Articles

Evaluation of near-infrared digital imaging transillumination compared with bitewing radiography for proximal caries detection in children.

Limitations in traditional caries detection tools have driven the development of alternatives methods, focused on the early lesion detection such as near-infrared digital imaging transillumination (NIDIT). The aim of this study was to evaluate the performance of NIDIT compared with bitewing radiography (BWR) in the detection of interproximal carious lesions in children. A retrospective audit of data from children who had NIDIT, BWR and intraoral photographs was conducted. Carious lesions were scored on a tooth surface level with BWR acting as the primary reference for comparison. Accuracy was determined using multi-class area under the curve (AUC), and correlation was determined using Fleiss' Kappa. Data from 499 tooth surfaces involving 44 children were included in this study. The average age across the participants was 86 months (~7 years) with an average dmft (decayed, missing and filled teeth in primary dentition) of 5.29. Multi-class AUC comparing NIDIT to BWR was 0.70. The correlation between NIDIT and BWR was moderate (0.43), whereas the correlation between photographic examination and BWR was 0.30, which is fair. When compared to BWR, NIDIT showed a high specificity but a low sensitivity for proximal caries detection in primary teeth.

Caries Detection in Primary Teeth Using Intraoral Scanners Featuring Fluorescence: Protocol for a Diagnostic Agreement Study.

Digital methods that enable early caries identification can streamline data collection in research and optimize dental examinations for young children. Intraoral scanners are devices used for creating 3D models of teeth in dentistry and are being rapidly adopted into clinical workflows. Integrating fluorescence technology into scanner hardware can support early caries detection. However, the performance of caries detection methods using 3D models featuring color and fluorescence in primary teeth is unknown. This study aims to assess the diagnostic agreement between visual examination (VE), on-screen assessment of 3D models in approximate natural colors with and without fluorescence, and application of an automated caries scoring system to the 3D models with fluorescence for caries detection in primary teeth. The study sample will be drawn from eligible participants in a randomized controlled trial at the Royal Children's Hospital, Melbourne, Australia, where a dental assessment was conducted, including VE using the International Caries Detection and Assessment System (ICDAS) and intraoral scan using the TRIOS 4 (3Shape TRIOS A/S). Participant clinical records will be collected, and all records meeting eligibility criteria will be subject to an on-screen assessment of 3D models by 4 dental practitioners. First, all primary tooth surfaces will be examined for caries based on 3D geometry and color, using a merged ICDAS index. Second, the on-screen assessment of 3D models will include fluorescence, where caries will be classified using a merged ICDAS index that has been modified to incorporate fluorescence criteria. After 4 weeks, all examiners will repeat the on-screen assessment for all 3D models. Finally, an automated caries scoring system will be used to classify caries on primary occlusal surfaces. The agreement in the total number of caries detected per person between methods will be assessed using a Bland-Altman analysis and intraclass correlation coefficients. At a tooth surface level, agreement between methods will be estimated using multilevel models to account for the clustering of dental data. Automated caries scoring of 3D models was completed as of October 2023, with the publication of results expected by July 2024. On-screen assessment has commenced, with the expected completion of scoring and data analysis by March 2024. Results will be disseminated by the end of 2024. The study outcomes may inform new practices that use digital models to facilitate dental assessments. Novel approaches that enable remote dental examination without compromising the accuracy of VE have wide applications in the research environment, clinical practice, and the provision of teledentistry. Australian New Zealand Clinical Trials Registry ACTRN12622001237774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384632. DERR1-10.2196/51578.

Assessment of the Caries Detection Ability of Quantitative Light-induced Fluorescence (QLF) in Primary Teeth <italic>in vitro</italic>

The aim of this study was to evaluate QLF (quantitative light-induced fluorescence) technology for the caries detection in primary teeth and validate the relationships between the cavity volume of carious lesions and QLF analysis results. Total 125 tooth surfaces include 53 occlusal surfaces, and 72 proximal surfaces were investigated with the portable QLF device for detection of dental caries in primary molars. Micro-CT radiograph was also performed to classify carious lesions and calculate the cavity volume. QLF showed good accuracy and reliability (sensitivity 0.75 - 0.94, specificity 0.82 - 0.95, and AUROC 0.88 - 0.98) for the caries detection in primary teeth except ΔR average results of proximal caries which showed relatively low values. Statistically significant relationships were found between ΔF average, QS-Index and the cavity volume according to Spearman rank-order correlation coefficients (r = 0.805 - 0.832, p < 0.001). QLF detection method would be a harmless and reliable way for children to diagnose dental caries without the concern about radiation exposure.

The diagnostic efficacy of quantitative light-induced fluorescence in detection of dental caries of primary teeth

ObjectivesTo evaluate a quantitative light-induced fluorescence (QLF) caries detection method using a portable device under clinical conditions and present a QLF scoring index (QS-index) for primary teeth. MethodsA total of 878 tooth surfaces (proximal and occlusal) of 44 children were studied. After visual inspection and radiographic examination, images of dental caries captured with the QLF device were classified according to caries progression stages and analyzed with a specialized software. Cut-off values, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for the QLF parameters: fluorescence loss (ΔF) and bacterial activity (ΔR). The reliability of logistic regression model to combine ΔF and ΔR was evaluated by the AUROC. ResultsQLF parameters showed a good sensitivity (0.72–0.91), specificity (0.74–0.96), and AUROC (0.861–0.940). The AUROC of logistic regression model (0.90–0.957) was higher than ΔF or ΔR average alone in all types of carious lesions. Every level of the QS-index was properly defined to represent the progression of dental caries with corresponding statistical significance. ConclusionsThe reliability of QLF for dental caries detection in primary teeth was similar to or slightly higher than that of the traditional diagnostic methods of visual inspection or radiographic examination in clinical conditions. Clinical significanceThe results of QLF were reliable in detecting all types of dental caries in primary teeth. The QLF method can provide visual images as well as quantitatively analyze the carious lesion.

In vivo correlation of near-infrared transillumination and visual inspection with bitewing radiography for the detection of interproximal caries in permanent and primary teeth.

To evaluate near-infrared light transillumination (NILT) for interproximal caries detection in children by comparing the correlation between both NILT and visual inspection (ICDAS) with bitewing (BW) radiography and by investigating possible differences in caries detection with NILT between primary and permanent teeth. From 35 patients, 121 and 63 interproximal surfaces in, respectively, primary and permanent teeth were included. NILT images were obtained using DIAGNOcam™ (KaVo) and scored by two calibrated raters. A consensus diagnosis was reached for BW radiography; whereas, the ICDAS scores were obtained by one calibrated rater. Weighted Kappa (wκ) was used to evaluate inter- and intra-rater reliability of NILT and to evaluate the correlation between NILT, ICDAS and BW radiography. The correlation between NILT and BW radiography was moderate to substantial for primary teeth [Rater 1: wκ = 0.61 (95% CI = 0.49-0.75), Rater 2: wκ = 0.55 (95% CI = 0.41-0.69)] and fair for permanent teeth [Rater 1: wκ = 0.34 (95% CI = 0.15-0.53), Rater 2: wκ = 0.33 (95% CI = 0.08-0.58)]. The correlation between ICDAS and BW radiography was moderate for primary teeth [wκ = 0.49 (95% CI = 0.35-0.63)] and substantial for permanent teeth [wκ = 0.62 (95% CI = 0.32-0.92)]. No significant differences were found between primary and permanent teeth. NILT cannot be recommended as a single diagnostic tool for interproximal caries detection in primary teeth. The number of false negatives for dentine caries, especially in first primary molars, was too high. For the use in permanent teeth, NILT could be more accurate than BW radiography.

In vivo validity of proximal caries detection in primary teeth, with histological validation.

Detection and diagnosis of proximal caries in primary molars are challenging. The aim of this in vivo study was to assess the validity and reproducibility of four methods of proximal caries detection in primary molar teeth. Eighty-two children (5-10years) were recruited. Initially, 1030 proximal surfaces were examined using meticulous visual examination (ICDAS) (VE1), bitewing radiographs (RE), and a laser fluorescence pen device (LF1). Temporary tooth separation (TTS) was achieved for 447 surfaces, and these were re-examined visually (VE2) and using the LF pen (LF2). Three hundred and fifty-six teeth (542 surfaces) were subsequently extracted and provided histological validation. At D1 (enamel and dentine caries) diagnostic threshold, the sensitivity of VE1, RE, VE2, LF1, and LF2 examination was 0.52, 0.14, 0.75, 0.58, and 0.60 and the specificity values were 0.89, 0.97, 0.88, 0.85, and 0.77, respectively. At D3 (dentine caries) threshold, the sensitivity values were 0.42, 0.71, 0.49, 0.63, and 0.65, respectively, whereas specificity was 0.93 for VE1 and VE2, and 0.98, 0.87, and 0.88 for RE, LF1, and LF2 examinations, respectively. ROC analysis showed radiographic examination to be superior at D3 . Meticulous caries diagnosis (ICDAS) should be supported by radiographs for detection of dentinal proximal caries in primary molars.

Diagnostic accuracy of direct digital radiography and conventional radiography for proximal caries detection in primary teeth: A systematic review.

The present study was conducted to uncover the diagnostic accuracy of digital versus conventional radiographic methods for the detection of proximal caries in primary teeth. Two researchers independently involved in the search process to explore Medical Subject Heading terms "dental digital radiography," "dental radiography," "bitewing," "dental caries," and "primary teeth" using PubMed, Cochrane Library, Ovid SP, and SIGLE databases. Search was confined to the articles published in English language only, with time period limit January 1996 to April 2014 and a hand search was performed to retrieve additional citations. Explicit inclusion and exclusion criteria were applied to eliminate undesired studies. Critical appraisal of the retrieved articles was done using the quality rating based on Bader and co-workers criteria. A total of 129 articles were retrieved, among which 4 articles were included. All the four studies included were in vitro, of which two studies attained a high-quality score, whereas the other two attained average, and low scores based on Bader et al.'s criteria. A big lacuna exists in the literature, regarding the evaluation of radiographic systems in primary teeth, suggesting an immediate need for well conducted in vivo studies. The quality of available evidence can be regarded as fair but cannot be suggested to set a baseline, indicating a need to perform high-quality studies in a randomized sample to find out the accuracy of digital and conventional radiographs.

Comparison of Proximal Caries Detection in Primary Teeth between Laser Fluorescence and Bitewing Radiography: An in vivo Study

ABSTRACT%Background and objective: Proximal caries detection is of great importance because of the rapid rate of caries progression and the difficulty in determining the absence or presence of a lesion in primary dentition. Although, various methods for caries diagnosis offer good diagnostic performances, they provide varying sensitivities for detecting proximal carious lesions. The objective of this study was to compare, in vivo, the accuracy of DIAGNOdent and bitewing radiography at detecting proximal caries in primary teeth.Materials and methods: One Hundred and one primary maxillary and mandibular molars without obvious cavities of children between the age group of 3 and 10 years were included. The teeth were first subjected to DIAGNOdent examination followed by bitewing radiography. The specificity and sensitivity of the systems were calculated.Results: At the dentin caries (D3) level, the sensitivity of DIAGNOdent and bitewing radiography was 78.5%; at the enamel caries (D1 and D2) level it was 39.12% and for the sound teeth (D0) it was found to be 76.52%. A strong association was observed between the DIAGNOdent and the bitewing radiograph (p < 0.001).Conclusion: The DIAGNOdent can be used as an alternative diagnostic method in detection of proximal caries in primary teeth. But when seen at the each caries level, the DIAGNOdent is more accurate at the D0 and D3 threshold.How to cite this article: Mepparambath R, Bhat SS, Hegde SK, Anjana G, Sunil M, Mathew S. Comparison of Proximal Caries Detection in Primary Teeth between Laser Fluorescence and Bitewing Radiography: An in vivo Study. Int J Clin Pediatr Dent 2014;7(3):163-167.

Caries detection in primary teeth is less challenging than in permanent teeth

Introduction: Most studies about caries detection methods have been performed using permanent teeth. Primary teeth, however, present significant differences from permanent teeth; hence findings of these studies with permanent teeth cannot be extrapolated. The Hypothesis: Our hypothesis is that the caries diagnosis process in primary teeth is less challenging than in permanent teeth. This assertion is based on the fact that primary enamel is thinner and the caries process progresses faster in this type of teeth when compared to permanent teeth. For these reasons, the majority of caries lesions in primary teeth would be more evident and therefore, easily detected through visual inspection. Only a few number of caries lesions would be missed by visual inspection. Thus, adjunct diagnostic methods, such as radiographs, would be unnecessary for primary teeth. Evaluation of the Hypothesis: To evaluate this hypothesis, researchers should conduct studies about the performance of the caries detection methods avoiding selection bias and defining appropriate settings. Clinical trials randomizing the diagnostic strategies would be worthwhile. The evidence supporting the benefits of adjunct methods in detecting caries lesions in primary lesions is limited. However, clinical guidelines have recommended the use of the radiographic method to detect caries in primary teeth in all symptomless children. The confirmation of our hypothesis would lead to the need to re-evaluate such guidelines.

Performance of Laser Fluorescence for Residual Caries Detection in Primary Teeth

The aim of this study was to evaluate the performance of a visual-tactile examination and a laser fluorescence device for detecting residual dentinal caries after carious dentin removal with bur excavation, hand excavation and chemomechanical excavation (Carisolv()]. Thirty extracted coronal caries primary second molars were used. The caries infected dentin has been removed. A blinded examiner checked all cavities for residual caries using a visual-tactile examination and laser fluorescence. Then the teeth were sectioned through the prepared cavities and the two halves of each tooth were processed for light microscopy and Scanning Electron Microscopy (SEM). The presence or absence of residual caries was verified using polarized light microscopy as the gold standard. The cavity floor dentin after removing carious dentin was examined using SEM. In among all groups a significant difference is determined between visual-tactile examination and laser fluorescence (P<.05). There was an agreement between laser fluorescence or visual-tactile examination and histological gold standard (P>.05). In addition, SEM images of the surfaces with the caries removed have shown that a vast majority of the tubule openings is observed to be open in the samples of the Carisolv group in opposition to the other groups. The laser fluorescence system could be effective in checking the removal by other methods, such as bur or Carisolv and avoid excessive removal of the sound dentin.

Use of a ranked scoring system to detect occlusal caries in primary molars

The available literature concerning systems for occlusal caries detection in primary teeth is limited. The aim of this study was to compare in vitro a ranked scoring system for occlusal caries detection in primary molar teeth with bitewing radiography and to investigate the most accurate cut-off point for dentine caries detection when using this ranked scoring system. Sixty primary molar teeth were examined in vitro visually and by bitewing radiography (two examiners) using Ekstrand' criteria. Histological examination revealed that 13% were sound, 38% had enamel caries and the remainder had dentine caries. Similar accuracy was seen when comparing bitewing radiographs and visual examination for caries detection at the d3 threshold, while visual examination was more accurate at the d1 threshold. The most suitable cut-off for diagnosing caries at the d1 threshold was V1 (no/slight change in enamel translucency after air drying). Either V2 (opacity/discoloration visible without air drying) or V3 (enamel breakdown in opaque/discoloured enamel and/or greyish discoloration) were suitable cut-off points at the d3 threshold. Visual examination was more accurate than bitewing radiographs for detection at the d1 threshold (the cut-off point of V1). Either V2 or V3 can be used for caries detection at the d3 threshold.

Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods

Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods