Carious Teeth Research Articles

Comparison of intraoral and extraoral scanners for volumetric assessment before and after caries removal by the ICDAS score: a quantitative analysis.

Aimed to compare the volumetric calculations (VC) of intra-and-extraoral scanners on carious teeth before/after caries removal. 120 extracted human molars with ICDAS scores of 3, 4, and 5 were included. The teeth were scanned using an extraoral scanner (Ineos-X5, Dentsply Sirona) and three intraoral scanners (IOS) (iTero Element-5D, Align Technology; Primescan, Dentsply Sirona; Trios 4, 3Shape) before-and-after caries removal (CR). Eight Standard Tessellation Language (STL) data of each tooth sample were overlapped in Meshmixer (Autodesk) software for VC. Shapiro-Wilk, Paired Two-Sample T-test, repeated analysis of variance test statistics, and intraclass correlation coefficient (ICC) were used (p < 0.05). In initial VC, a significant difference observed between Ineos-X5 and iTero Element-5D (p < 0.001) and Ineos-X5 and Primescan (p < 0.001), regardless of the ICDAS score. No significant difference observed after CR between Ineos-X5 and iTero Element-5D (p = 0.917), Ineos-X5 and Primescan (p = 0.936), and Ineos-X5 and Trios 4 (p = 0.727) respectively. There was also no difference between the three IOS after CR (p ≥ 0.05), whereas the iTero Element-5D scanner significantly calculated less volume than Primescan and Trios-4 initially (p = 0.003). Maximum ICC was observed between the Ineos-X5 and Primescan in the ICDAS 5 score, before CR (ICC = 1, p < 0.001) and triple comparisons of iTero Element-5D, Primescan, and Trios-4 (ICC = 1, p < 0.001). Carious and irregular surfaces might affect the data collection of IOS. Intra-and-extraoral data may present negligible differences in the volumetric calculation, depending on the caries status and anatomical properties. These differences and factors may be important for future artificial intelligence networks that simulate the aftermath of caries removal. The IOSs tested in the current study can successfully collect data from irregular, deep and shallow cavities after caries removal.

Enhancement of early proximal caries annotations in radiographs: introducing the Diagnostic Insights for Radiographic Early-caries with micro-CT (ACTA-DIRECT) dataset

BackgroundProximal caries datasets for training artificial intelligence (AI) algorithms commonly include clinician-annotated radiographs. These conventional annotations are susceptible to observer variability, and early caries may be missed. Micro-computed tomography (CT), while not feasible in clinical applications, offers a more accurate imaging modality to support the creation of a reference-standard dataset for caries annotations. Herein, we present the Academic Center for Dentistry Amsterdam—Diagnostic Insights for Radiographic Early-caries with micro-CT (ACTA-DIRECT) dataset, which is the first dataset pairing dental radiographs and micro-CT scans to enable higher-quality annotations.MethodsThe ACTA-DIRECT dataset encompasses 179 paired micro-CT scans and radiographs of early proximal carious teeth, along with three types of annotations: conventional annotations on radiographs, micro-CT-assisted annotations on radiographs, and micro-CT annotations (reference standard). Three dentists independently annotated proximal caries on radiographs, both with and without micro-CT assistance, enabling determinations of interobserver agreement and diagnostic accuracy. To establish a reference standard, one dental radiologist annotated all caries on the related micro-CT scans.ResultsMicro-CT support improved interobserver agreement (Cohen’s Kappa), averaging 0.64 (95% confidence interval [CI]: 0.59–0.68) versus 0.46 (95% CI: 0.44–0.48) in its absence. Likewise, average sensitivity and specificity increased from 42% (95% CI: 34–51%) to 63% (95% CI: 54–71%) and from 92% (95% CI: 88–95%) to 95% (95% CI: 92–97%), respectively.ConclusionThe ACTA-DIRECT dataset offers high-quality images and annotations to support AI-based early caries diagnostics for training and validation. This study underscores the benefits of incorporating micro-CT scans in lesion assessments, providing enhanced precision and reliability.Graphical

Effects of glutathione and potassium iodide on silver diamine fluoride application on remineralisation and colour change in dentine caries of primary teeth: an in vitro study.

The aim of this study is to compare the effect of GSH (reduced glutathione) and KI (potassium iodide) on SDF (silver diamine fluoride) discolouration and dentine remineralisation. Sixteen primary molars were utilised, yielding 4 dentine specimens each. Three specimens per tooth were allocated: one as a control and the others to experimental groups. Initial microhardness measurements were taken from one remaining dentine specimen per tooth. Subsequently, all groups underwent exposure to a demineralisation solution. Colorimetry assessed specimen colour, and post-second microhardness measurements on demineralised specimens, treatments were administered as follows: group 1 (control, n = 16): 38% SDF, group 2 (n = 16): 38% SDF followed by KI, group 3 (n = 16): 38% SDF with 5% GSH added by weight. Following pH cycling across all groups, colorimetry reassessed 48 dentine specimens. Final microhardness measurements ensued, followed by statistical analysis. Normality was checked via Shapiro-Wilk, and homogeneity via Levene's test. Independent samples t test compared normally distributed groups; Mann-Whitney U compared non-normally distributed groups. ANOVA compared means of normally distributed groups, and Kruskal-Wallis for non-normally distributed ones. Repeated measures ANOVA compared dependent groups with normal distribution, and Friedman test for non-normal. Post hoc Bonferroni analyses identified significant differences. IBM SPSS 25 was used to conduct analyses. The mean ΔE* values for SDF and SDF + GSH groups were significantly higher than those of the SDF + KI group (p < 0.05). Significant differences in L* values during final colour measurement were noted between the SDF + KI group and both SDF and SDF + GSH groups (p < 0.05). Although mean remineralisation microhardness measurements were higher than mean demineralisation microhardness measurements in all groups, statistical significance was observed only in the SDF and SDF + KI groups (p < 0.05). The study found that the addition of 5% GSH by weight to SDF does not significantly affect discolouration. Moreover, the addition of 5% GSH to the SDF solution may have a minor impact on the remineralisation potential of SDF. The application of KI after SDF reduces discolouration and does not affect the expected remineralisation process.

Dental Emergency Rates at an Expeditionary Medical Facility Supporting Operation Inherent Resolve.

A core objective of U.S. medical services is to ensure the medical and dental readiness of military personnel. Oral diseases, resulting in pain, infection, or functional impairment, greatly affect the operational effectiveness of military personnel. This study aimed to compare the current causes of dental emergencies and the rates of dental disease nonbattle injuries in a deployed setting with those documented in previous research. Additionally, the study sought to determine if these rates have decreased because of preventive measures or potential improvements in overall oral health. Each soldier reporting to the health facility for dental care was screened by a dentist to determine the presence of a dental emergency. The reason for seeking care was classified into 1 of 7 categories and the rate of dental emergencies per 1,000 military members per calendar year was calculated. The majority of emergencies (38.60%) were due to tooth fractures and/or caries. The second most common reason for visiting the dental clinic was pain from a tooth requiring endodontic therapy (16.81%). This was followed by musculoskeletal or nonendodontic tooth pain (16.10%), most often associated with stress. Periodontal issues accounted for 14.33% of emergencies. Teeth requiring extraction made up 7.16% of all emergencies, prosthodontic bonding complications accounted for 5.16%, and orthodontic bonding complications affected 1.84% of individuals. The dental disease nonbattle injuries rates determined from the current study were 154 emergencies per 1,000 personnel per year for Air Force members and 264 emergencies per 1,000 personnel per year for Army members, which align with previous research findings. The results of this study confirm that dental emergencies continue to be a threat to overall readiness in deployed environments. The primary etiologic factor in the current study was as a result of tooth fracture and/or caries.

Comparing Military and Civilian Dentists' Treatment Planning Decisions: A Pilot Study.

Clinical decision-making varies among dentists. However, the literature is limited and narrow in scope regarding the variation between public and private sector dentists. Because both types of dentists' decisions can directly influence military dental readiness, it is important to understand the potential differences in diagnosis, treatment planning, and the delivery of care. The purpose of this pilot study was to compare treatment planning recommendations between civilian and military providers. Patient-level data from the 2018 Recruit Surveillance, a stratified, cross-sectional study of 1,208 randomly selected U.S. Air Force recruits, were used to evaluate treatment planning outcomes for the 2 provider groups (2 civilians; seven military providers). Treatment planning outcomes included type of noninvasive, operative, and oral surgery treatment recommended, temporomandibular disorder referrals, and orthodontic referrals. Patient demographic variables included age, gender, education, race/ethnicity, and military component ("status"). Data were examined both at the tooth level and patient level for statistical significance. Multivariate analyses were performed with statistically significant variables included in each final model for patient-level data. Data were analyzed with logistic regression and Poisson regression (alpha = 0.05). Bivariate logistic regression analyses were performed for tooth-level data. Significant differences were found between military and civilian dentists' treatment planning decisions (P < .05) for both patient-level and tooth-level data. Adjusted for significant bivariate predictors of patient demographics at the patient level, civilian dentists were more likely to refer patients for orthodontic treatment, prescribe remineralization for sound tooth surfaces, incipient caries, and carious teeth, and prescribe direct restorations for teeth with 3 to 5 carious surfaces instead of single crowns compared to military dentists. Additionally, civilian dentists were less likely to prescribe sealants for sound tooth surfaces or carious teeth. No statistically significant difference in treatment planning outcomes was observed between civilian and military dentists for sealants for incipient caries, single crowns, or extraction of third molars. At the tooth level, civilian dentists were more likely to prescribe remineralization for sound tooth surfaces, remineralization instead of sealants for carious surfaces, and extraction of third molars. No statistically significant differences were noted between civilian and military providers for recommending sealant or remineralization for teeth with incipient caries or prescribing a single crown versus placing a direct restoration on posterior teeth with 3 to 5 carious surfaces. Significant differences in treatment planning outcomes between civilian and military providers exist. Civilian providers are more likely to refer patients for orthodontic treatment and prescribe remineralization, direct restorations instead of single crowns, and third molar extractions, while military providers are more likely to prescribe sealants for sound tooth surfaces or carious teeth. Therefore, comparisons of treatment planning outcomes between civilian and military providers warrant further research.

The Potential of Silver Diamine Fluoride in Non-Operative Management of Dental Caries in Primary Teeth: A Systematic Review

Background and Objectives: Dental caries has seen an increase in untreated cases, leading to significant health and quality-of-life impacts, necessitating innovative approaches like the promising non-operative management with silver diamine fluoride. This study aimed to evaluate the mechanisms of action of silver diamine fluoride on arresting dental caries in primary teeth. Materials and Methods: A systematic search was conducted across MEDLINE (PubMed), Google Scholar, and Wiley Online Library, including both in vivo and in vitro studies published from 1 January 2017 to 16 October 2022. The Cochrane Risk of Bias Tool assessed bias in in vivo studies, while the Quality Assessment Tool for In Vitro Studies evaluated the methodological quality of in vitro studies. Results: Nineteen publications met the inclusion criteria. Two studies indicated that silver diamine fluoride application significantly alters oral microflora, contributing to caries arrest. Additionally, two studies reported increased mineral density and mineral content in demineralised primary teeth, emphasising silver diamine fluoride’s role in promoting remineralisation. Three studies demonstrated significant improvements in surface microhardness, enhancing tooth resistance. However, no significant qualitative changes in bacterial species composition were noted. Modified silver diamine fluoride application techniques, including light curing or laser irradiation, enhanced efficacy, with light curing notably increasing surface microhardness. Based on a limited number of studies, no statistically significant differences in clinical effectiveness were observed with higher silver diamine fluoride concentrations or extended application durations. Conclusions: Silver diamine fluoride effectively induces quantitative changes in oral microflora and enhances the microhardness and mineral density of enamel and dentine in primary teeth, with modified application methods showing potential for improved outcomes.

Oral health-related beliefs among a sample of pregnant women in Southwestern Ontario: a descriptive study.

Unfavorable beliefs about oral health and dental treatment during pregnancy can lead to the avoidance of dental care and the underutilization of dental services, adversely affecting adherence to good oral hygiene practices and, consequently, the health of the fetus. This study investigated the commonly held oral health beliefs among pregnant women in Southwestern Ontario, Canada. Participants were recruited from the Family Medicine Obstetrics Clinic in London, Ontario, Canada. Eligible participants were pregnant women aged 18 or older, excluding those unwilling to participate. Participants completed a 33-item self-administered questionnaire, including three open-ended questions about oral health beliefs and their impacts on pregnancy, which were analyzed for this study. Thematic analysis in NVivo identified key patterns, while analysis determined the most common beliefs and the degree of diversity in responses. Responses were categorized into sub-themes, and the frequency and percentage of each category were calculated. A total of 130 participants met the inclusion criteria. Among them, 40.7% (n = 46) believed that oral health impacts their child's health, 48.2% (n = 53) believed that dental treatment affects fetal health, and 64.4% (n = 76) believed that pregnancy influences their oral health. Many beliefs regarding oral health during pregnancy regarded infection risks. Participants held negative beliefs about the effects of antibiotics, analgesics, and dental x-rays during pregnancy. Common beliefs about the impacts of pregnancy on oral health included developing conditions, such as tooth sensitivity, caries, and gingivitis, as well as a loss of minerals to the fetus. This study revealed important misconceptions and concerns about oral health and dental treatment among pregnant women in Southwestern Ontario. The findings highlighted the need for enhanced oral health education for pregnant women to address these misconceptions and promote proper care during pregnancy. Healthcare providers are encouraged to focus on dispelling myths, emphasizing the safety of necessary dental treatments, and reinforcing the significance of maintaining good oral health for maternal and fetal well-being.

Efficacy of vital pulp therapy for carious pulp injury in permanent teeth: a study protocol for an open-label randomized controlled noninferiority trial.

Vital pulp therapy (VPT) has recently been reported as an effective approach for preventing and treating carious pulp injury in permanent teeth. Compared with root canal treatment (RCT), which involves complete removal of the pulp tissue, VPT effectively maintains pulp vitality and retains the physiological functions of the pulp. In the research pool, large-scale randomized controlled trials evaluating the treatment outcome of VPT using calcium silicate cements and RCT in cariously exposed permanent teeth are lacking. Here, we present a monocentric clinical protocol to compare the effects of VPT using iRoot BP Plus (Innovative Bioceramix, Vancouver, BC, Canada) as a pulp-capping material with RCT. The proposed trial is an open-label, single-centre, randomized, controlled, noninferiority trial. In total, 462 patients will be included in this trial according to the following criteria: adult patients (18-50years old), pulp exposure during the treatment of deep caries in mature permanent teeth, a diagnosis of reversible or partially irreversible pulpitis without apical translucency on X-ray, without periodontitis or systemic disease. Patients with signed informed consent forms will be enrolled and randomly divided into two groups (VPT and RCT) with a balanced treatment allocation (1:1). Clinical evaluations will be conducted at baseline and at 3, 6, 12, and 24months after treatment, with the potential for extension. The primary outcome measure will be the duration of success. The secondary outcomes will include the success rate at the 1-year follow-up and any adverse reactions. The Kaplan‒Meier method and log-rank test will be used to compare the duration of success of both treatments. For other outcomes, the χ2 test or Fisher's exact test will be used for categorical variables, and the t test or Mann‒Whitney U test will be used for continuous variables to assess the differences between groups. The results of this trial will provide a clinical reference for selecting treatments for carious pulp injuries in permanent teeth. ClinicalTrials.gov ChiCTR2100051369. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn ). Registered on 21 September 2021.

Caries Detection and Classification in Photographs Using an Artificial Intelligence-Based Model-An External Validation Study.

This ex vivo diagnostic study aimed to externally validate a freely accessible AI-based model for caries detection, classification, localisation and segmentation using an independent image dataset. It was hypothesised that there would be no difference in diagnostic performance compared to previously published internal validation data. For the independent dataset, 718 dental images representing different stages of carious (n = 535) and noncarious teeth (n = 183) were retrieved from the internet. All photographs were evaluated by the dental team (reference standard) and the AI-based model (test method). Diagnostic performance was statistically determined using cross-tabulations to calculate accuracy (ACC), sensitivity (SE), specificity (SP) and area under the curve (AUC). An overall ACC of 92.0% was achieved for caries detection, with an ACC of 85.5-95.6%, SE of 42.9-93.3%, SP of 82.1-99.4% and AUC of 0.702-0.909 for the classification of caries. Furthermore, 97.0% of the cases were accurately localised. Fully and partially correct segmentation was achieved in 52.9% and 44.1% of the cases, respectively. The validated AI-based model showed promising diagnostic performance in detecting and classifying caries using an independent image dataset. Future studies are needed to investigate the validity, reliability and practicability of AI-based models using dental photographs from different image sources and/or patient groups.

Validity assessment of a third-generation light-induced fluorescence device in detecting proximal and occlusal caries lesions: A cross-sectional study

ObjectivesThe objective of this study was to evaluate the efficacy of a quantitative light-induced fluorescence (QLF) device (QrayCam Pro, AIOBIO, Seoul, Republic of Korea) in detecting and differentiating the severity of posterior proximal and occlusal primary caries. Materials and methodsThe study included a total of 120 teeth in 60 patients (of both genders, aged between 21 and 38 years) between January and March 2024, one carious tooth and one sound tooth were selected at random in each patient. All occlusal surfaces were evaluated in accordance with the International Caries Detection and Assessment System (ICDAS) Nyvad Criteria, using the visual tactile method. The ICDAS employs a scoring system ranging from 0 to 6, while the Nyvad Criteria employs a similar scoring system. Addionally, the depth of the proximal lesions was scored (0–6) using bite-wing radiography. The quantitative values representing the maximum loss of fluorescence (∆Fmax) and the maximum change in the ratio of red and green fluorescence (∆Rmax) were obtained using the Q-ray Clinical software v 1.45. To assess the validity, the sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) were calculated. Spearman correlation coefficient was used to investigate the correlation between the findings of the traditional and QLF examination methods. ResultsThe AUROC values for both ∆Fmax and ∆Rmax were found to be excellent. The sensitivity of QrayCam Pro was found to be 84–88.6%, while the specificity was 100%. The correlation analysis demonstrated a strong correlation between scores obtained from the traditional examination and the QLF values. ConclusionsBased on the findings of this study, QrayCam Pro exhibits potential as a valuable additional tool for not only detecting caries but also for assessing their severity and activity. Clinical relevanceThis study revealed that QrayCam Pro might be suggested as a precise tool for enhancing caries detection and assessment compared to traditional methods. By providing quantitative data on caries severity and activity, it enables more informed treatment decisions, potentially optimizing outcomes for patients.

Oro-Dental Characteristics in Patients With Adult-Onset Hypophosphatasia Compared to a Healthy Control Group-A Case-Control Study.

Hypophosphatasia (HPP) is a rare inherited disease that affects multiple organ systems including bone and teeth. Limited knowledge exists on dental and oral health in patients with adult-onset HPP (aHPP). The aim of this study was to investigate oro-dental characteristics in patients with aHPP compared to healthy controls. This case-control study included 20 patients with aHPP compared to 31 healthy controls. Oro-dental manifestations were examined by standardised interviews, clinical examinations as well as radiological registrations on panoramic radiograph (OP) and cone-beam computed tomography (CBCT) scans. The subjective experience of tooth fractures (p = 0.010), caries in permanent teeth (p = 0.032) and early loss of permanent teeth (p = 0.002) was significantly higher in patients with aHPP compared to the controls. In the aHPP group, the presence of specific teeth (p ≤ 0.045) and attrition of 11 were significantly lower (p = 0.012) compared to the controls. Opacity of a few teeth (p ≤ 0.049), presence of denticles (p = 0.024), the distance between the enamel-cement junction (CEJ) and the marginal bone level at specific sites (p ≤ 0.021) and crown height of 11 (p = 0.017) were significantly higher in patients with aHPP than in healthy controls. The results indicate that patients with aHPP have a subjective experience of having poorer dental health. Loss of permanent teeth, less attrition, tooth opacities, denticles and larger distance between CEJ and marginal bone level are possible oro-dental findings in patients with aHPP.

In Vitro Models Used in Cariology Mineralisation Research-A Review of the Literature.

Dental caries remains a significant global health problem. One of the fundamental mechanisms underlying the development and progression of dental caries is the dynamic process of demineralisation/remineralisation. In vitro models have played a critical role in advancing our understanding of this process and identifying potential interventions to prevent or arrest dental caries. This literature review aims to provide a structured oversight of in vitro mineralisation models which have been used to study the tooth demineralisation/remineralisation process. Publications from 2019 to 2023 were screened to identify articles reporting the use of in vitro models to study the demineralisation/remineralisation of tooth caries. The included studies were methodologically assessed for their information on (i) substrate, (ii) lesion formation, and (iii) mineralisation models. The most reported substrates used in the studies were human teeth along with bovine incisors. Acetic/lactic buffers were the most common solutions to induce caries lesions. pH cycling was the most frequently used mineralisation model for simulating the daily change within the oral environment. This review discussed the advantages and limitations of various approaches. Standardisation of in vitro mineralisation models is crucial for enabling effective comparison between studies and advancing caries research.

Clinical Validation of Deep Learning for Segmentation of Multiple Dental Features in Periapical Radiographs.

Periapical radiographs are routinely used in dental practice for diagnosis and treatment planning purposes. However, they often suffer from artifacts, distortions, and superimpositions, which can lead to potential misinterpretations. Thus, an automated detection system is required to overcome these challenges. Artificial intelligence (AI) has been revolutionizing various fields, including medicine and dentistry, by facilitating the development of intelligent systems that can aid in performing complex tasks such as diagnosis and treatment planning. The purpose of the present study was to verify the diagnostic performance of an AI system for the automatic detection of teeth, caries, implants, restorations, and fixed prosthesis on periapical radiographs. A dataset comprising 1000 periapical radiographs collected from 500 adult patients was analyzed by an AI system and compared with annotations provided by two oral and maxillofacial radiologists. A strong correlation (R > 0.5) was observed between AI perception and observers 1 and 2 in carious teeth (0.7-0.73), implants (0.97-0.98), restored teeth (0.85-0.89), teeth with fixed prosthesis (0.92-0.94), and missing teeth (0.82-0.85). The automatic detection by the AI system was comparable to the oral radiologists and may be useful for automatic identification in periapical radiographs.

Proteome of the 2-h in vivo Formed Acquired Enamel Pellicle of Adolescents with Erosive Tooth Wear, Caries, or Sound

Introduction: Acquired pellicle (AP) acts as a membrane preventing acids from coming into direct contact with the tooth. Possibly, individuals with different dental health status present changes in its composition that could disrupt this function. Thus, the aim of this study was to compare the protein composition of the AP in adolescents with erosive tooth wear (ETW), caries, or sound. Methods: Calibrated examiners in BEWE index and ICDAS-merged Epi criteria assessed ETW and caries in a sample of 454 systemically healthy adolescents aged 12–15 years old. Thirty subjects from that sample were selected for this study: ETW group (n = 10; total BEWE ≥9 and absence of dentinal caries lesions); caries group (n = 10; total BEWE <9 and with at least one dentinal caries lesion), and sound group (n = 10; total BEWE <9 and absence of dentinal caries lesions). Two-hour-formation AP samples were taken from buccal, occlusal/incisal, palatal/lingual tooth surfaces. Protein composition was analysed by liquid chromatography-tandem mass spectrometry. Using mean reporter ion values, relative abundances of proteins were compared among the three groups to calculate for fold changes. Twofold protein increases or decreases were reported (t test, p < 0.05). Gene Ontology (GO) of included proteins was assigned. Results: Mean age of participants was 13.1 ± 1.14 years and 56.6% were females. The prevalence of ETW was of 66.6% and of dentinal caries of 33.3%. The GO analyses showed that the majority of detected proteins were stress response related. The ETW group disclosed upregulated relative abundance of antileukoprotease (2.85-fold in ETW vs. sound and 2.34-fold in ETW group vs. caries group); histatin (2.42-fold in ETW group vs. sound group and 2.20-fold in ETW group vs. caries group), and prolactin-induced protein (2.30-fold in ETW group vs. sound group and 2.06-fold in ETW group vs. caries group) (p < 0.05). Hemoglobin subunits alpha (HBA) and beta (HBB) showed decreased relative abundances in the ETW and caries groups when compared to the sound group (HBA: 0.42-fold in ETW group and 0.40-fold in caries group; HBB: 0.45-fold in ETW group and 0.38-fold in caries group; p < 0.05). Conclusion: AP from individuals with ETW showed differences when compared to other dental conditions, with relative abundance increasing of some stress response-associated proteins in ETW and a decrease in proteins related to salivary protection against acid challenges.

Patterns of mandibular third molar impaction and its relationship with distal caries in the adjacent mandibular second molars: A retrospective study

BackgroundImpacted third molars can cause significant challenges for dental health. While many of these impacted teeth remain asymptomatic, they can lead to dental caries. ObjectiveTo investigate the patterns of mandibular third molar impaction and its relationship with the occurrence of caries in the adjacent mandibular second molars. Materials and MethodsThis study assessed the dental panoramic radiographs of 1591 participants who visited the Department of Oral and Maxillofacial Surgery at the Dental Teaching Hospital at Umm Al-Qura University between 2022 and 2024. The presence of distal caries in the adjacent mandibular second molars was assessed and compared across the different impaction patterns, considering both age and gender. ResultsThe results showed that 29.22 % of the patients had impacted mandibular third molars. The most common patterns of impacted mandibular third molar angulation were mesioangular in the females and horizontal in the males. The majority of these impacted third molars were level A and class I (as per the Pell and Gregory classification).One hundred and eighty-three (39.35 %) of the impacted mandibular third molars had associated carious lesions, with 89 showing distal caries in the adjacent mandibular second molar and 18 showing caries in the third molar itself. The carious lesions were most commonly found in cases of mesioangular, level A, and class I impaction patterns (p < 0.05). ConclusionThe findings of this study shed light to the high prevalence of carious lesions associated with impacted mandibular third molar, especially in cases of mesioangular, level A, and class I impaction patterns. These findings highlight the importance of careful monitoring of impacted third molars to prevent the development of caries in the adjacent teeth.

Artificial intelligent model for detecting caries in primary teeth

Artificial intelligent model for detecting caries in primary teeth

Dental Caries and Erosive Tooth Wear Among 12-Year-Old Hong Kong Children

ObjectiveThis study is to investigate the dental caries, erosive tooth wear status, and oral health-related habits of 12-year-old Hong Kong children. MethodsThis cross-sectional survey recruited 12-year-old children using clustered random sampling from three main districts. The trained examiner examined the children's caries status using the criteria recommended by the World Health Organization and recorded their caries experience using the decayed, missing, and filled tooth (DMFT) index. The children's tooth wear status was determined using the Basic Erosive Wear Examination (BEWE) index. Their oral hygiene practice was collected using a self-administered questionnaire. ResultsWe recruited 445 children and 396 children participated (response rate: 89%). Their mean DMFT was 0.29 ± 0.73. Seventy children (18%, 70/396) had caries experience (DMFT > 0) and they had 116 teeth suffered from caries. Among these 116 carious teeth, 75 teeth (65%, 75/116) were filled (FT), one tooth (1%, 1/116) was extracted (MT), and 40 teeth (34%, 40/116) were carious (DT). Five children had more than one decayed tooth (DT > 1), and one child had the highest number of decayed teeth (DT) at 4. BEWE results showed 284 (72%, 284/396) children had no erosive tooth wear (BEWE = 0). No child had severe erosive tooth wear (BEWE = 3). However, children consuming lemon tea or lemonade and vitamin C drinks 3 times a week or more showed significantly higher BEWE scores. Additionally, 380 (96%, 380/396) children brushed their teeth daily and 116 children (29%, 116/396) flossed their teeth. ConclusionMost 12-year-old Hong Kong children had neither caries experience nor tooth wear, and their oral health-related habits were satisfactory. SignificanceThis study updated the caries status of the permanent dentition of 12-year-old Hong Kong children. The information offers updated oral health data for the local, regional, and global authorities for planning effective public health programmes to improve the oral health of children.

The role of visual aids in the clinical success of posterior restorations: Randomized controlled clinical trial

ObjectiveThis clinical study aimed to assess the impact of utilizing loupes and dental operating microscopes (DOM) with varying magnifications on the success of class II direct composite restorations. MethodsA total of 130 class II, moderately deep caries teeth from 85 patients were randomly assigned to four groups: naked eye, ×3 loupe, ×5 loupe, and ×8.5 DOM. Cavities were restored with or without magnification. The restorations were evaluated according to World Dental Federation criteria at 1, 6, and 12-month intervals by previously calibrated evaluators. Cochran's Q test was used to compare paired scores across three or more time points within groups, while the Friedman test was employed to compare scores at three or more time points. Multiple comparisons were adjusted using the Bonferroni correction. The significance level was set at p < 0.05. ResultsStatistical analysis revealed no significant differences among the groups at the 1-, 6-, and 12-month follow-up periods (p > 0.05). Although not statistically significant, the magnified groups exhibited higher scores in aesthetic anatomical form, proximal form, postoperative sensitivity, periodontal response, and adjacent mucosalcriteria compared to the naked eye group. ConclusionAlthough no statistically significant difference was observed at the 12-month follow-up between restorations performed with and without magnification, the groups using magnification showed higher scores.

Assessment of Severity and Pattern of Early Childhood Caries Using ICDAS II Criteria: A Descriptive Cross-sectional Study

Introduction: Early childhood caries is highly prevalent worldwide. The International Caries Detection and Assessment System incorporates both the non-cavitated and cavitated carious lesions with acceptable reliability. The objective of the present study was to assess the severity and pattern of early childhood caries among children visiting outpatient department of a dental college in Nepal. The study also aimed to compare the severity and pattern based on individual tooth type. Methods: A cross-sectional study was conducted among children of age group 24-71 months in primary dentition stage. The International Caries Detection and Assessment System II criteria was used to detect dental caries, and its severity and pattern. The ethical approval was taken from the institutional ethical committee (IRC Ref. No.: 1, 36, 2079/2080 IRC PDCH 2022 21).Results: The dental cries in children of age group 48-60 months was 1338 (33.46%) and dentinal caries (Code 5) was observed in 112 (8.37%). Multi-surface caries was 644 (16.15%), and occlusal surface caries was 481 (12.06%). Among the study population, 227 (5.69%) of the teeth assessed were associated with restoration and sealants. Enamel caries among the maxillary second molars (55/65) (Code 3) was in 94 (23.5%), and the dentinal caries (Code 5) in maxillary central incisors (51/61)was in 90 (22.78%). Conclusions: Majority of the children enrolled in the study had multiple cavitated and non-cavitated carious teeth involving different surfaces. Severity and pattern of caries also varied among individual tooth type.

Benefits of using virtual reality in cariology teaching

BackgroundVirtual Reality (VR) has been widely used as an useful educational tool in modern dentistry and is considered as an alternative training tool adjunct to conventional training methods.ObjectiveThis study was designed to investigate the effectiveness of VR haptic-enhanced simulators for training undergraduate dental students during practical cariology pre-clinical caries excavation sessions.MethodsA total number of 76 students were recruited for this study. Students were randomly divided into 2 groups (38 students each). The experimental group (VR-Start group), students performed caries removal at the VR haptic-enhanced simulator prior to practicing on natural extracted teeth. Conversely, the control group (Natural Tooth-Start Group), students exposed to VR simulation training after practicing on extracted natural teeth. An evaluation questionnaire was disseminated among students to evaluate their self-confidence, perceived clinical skills and their perception of providing better care to patients in the future. They were also invited to express their opinions on the usefulness of VR simulator in comparison with conventional learning methods.ResultsThe outcome of Chi-square test showed no significant difference in students’ response among this study groups (p > 0.05). Moreover, the outcome of this study revealed that both student groups considered virtual reality as a useful learning tool. Majority of students (90%) superiorly ranked experience gained from practicing on natural carious teeth. They also clearly stated that virtual reality allowed them to practice more and improve their self-confidence level as well as eye-hand coordination.ConclusionsVirtual reality simulator is a useful learning tool which can benefit undergraduate dental students at their pre-clinical stage; but, it cannot totally replace the conventional caries excavation.