International Caries Detection And Assessment System Research Articles

Diagnostic Strategies for Restorations Management: A 70-Month RCT.

We aimed to evaluate the impact of 2 visual diagnostic strategies for assessing secondary caries and managing permanent posterior restorations on long-term survival. We conducted a diagnostic cluster-randomized clinical trial with 2 parallel groups using different diagnostic strategies: (C+AS) based on caries assessment, marginal adaptation, and marginal staining aspects of the FDI (World Dental Federation) criteria and (C) based on caries assessment using the Caries Associated with Restorations or Sealants (CARS) criteria described by the International Caries Detection and Assessment System (ICDAS). The treatment for the restoration was conducted based on the decision made following the allocated diagnostic strategy. The restorations were then clinically reevaluated for up to 71 mo. The primary outcome was restoration failure (including tooth-level failure: pain, endodontic treatment, and extraction). Cox regression analyses with shared frailty were conducted in the intention-to-treat population, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were derived. We included 727 restorations from 185 participants and reassessed 502 (69.1%) restorations during follow-up. The evaluations occurred between 6 and 71 mo. At baseline, C led to almost 4 times fewer interventions compared with the C+AS strategy. A total of 371 restorations were assessed in the C group, from which 31 (8.4%) were repaired or replaced. In contrast, the C+AS group had 356 restorations assessed, from which 113 (31.7%) were repaired or replaced. During follow-up, 34 (9.2%) failures were detected in the restorations allocated to the C group and 30 (8.4%) allocated to the C+AS group in the intention-to-treat population, with no significant difference between the groups (HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435, C+AS as reference). In conclusion, a diagnostic strategy focusing on marginal defects results in more initial interventions but does not improve longevity over the caries-focused strategy, suggesting the need for more conservative approaches.

Do progression rates of initial and moderate caries lesions and sound surfaces of primary teeth increase significantly after 7 years?

Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups. To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years. This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors. IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome. The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.

Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial

AimsThis study aimed to evaluate the visual improvement of resin infiltration of white spot lesions (WSL) during orthodontic treatment with the multibracket appliance (MBA) compared to fluoride varnish.MethodsPatients aged 12–17 years with at least one WSL with an International Caries Detection and Assessment System (ICDAS) score of 1–2 during an active MBA treatment were included and randomized to receive either resin infiltration (Icon) or fluoride application (Flairesse). Standardized digital images were obtained before, one-day, one-week, one-month, three-months and six-months after treatment using a DSLR camera and a matching polarization filter. A grey reference card was used for color standardization. A Matlab routine was used to measure the color difference between adjacent healthy enamel and treated WSL. The independent-samples t-test was used for intergroup and paired-samples t-test for intragroup comparison.ResultsImages of 116 teeth from 36 patients were analyzed. The ΔE for the “Icon” treated WSL was smaller (T1ICON = 5.0 ± 1.4) than in the fluoride group (T1Fluoride = 8.4 ± 3.2). Caries infiltration significantly improved the aesthetic appearance of WSL (p < 0.001), which remained satisfactory at six months (T5ICON = 5.2 ± 1.6).ConclusionWSL infiltration management during orthodontic treatment was superior to topical fluoridation in not only arresting the enamel lesions but also significantly improving the aesthetic appearance of demineralized regions around the brackets.Clinical relevanceWSL treatment in orthodontic patients is usually initiated after debonding. Research has shown that the earlier WSL is treated, the better the aesthetic outcome. There is limited data on the efficacy of resin infiltration of WSL during orthodontic treatment.

Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients.

Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex. The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR). The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI). The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values. The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.

Progression of proximal caries in primary molars using the radiographic ICDAS: a retrospective cohort study.

To evaluate the proximal caries progression in primary molars using the radiographic International Caries Detection and Assessment System (ICDAS). A study was conducted on 196 children aged 3-9 years old who underwent the clinical examination and bitewing radiography during baseline and 6-month (and over) follow-up visits. The primary molars bitewing radiographs with initial enamel caries (RA1 and RA2) or outer dentine caries (RA3) of proximal surfaces were included. Caries advancement was scored using ICDAS criteria and statistical analyses with the chi-square test. Median survival time was evaluated using Kaplan-Meier survival curves and log-rank tests. A total of 439 surfaces of primary molars were included in this study and an averaged follow-up period of enamel and dentine caries group were 18.3 ± 9.6 months and 16.5 ± 9.5 months respectively. The progression of proximal enamel lesions significantly differed between primary maxillary and mandibular molars (p = 0.002) and among each patient's primary mandibular second molar and the others (p = 0.002). On the contrary, the outer dentine caries of each group of primary molars was not different. The median survival time of the initial enamel proximal caries (23.30 months) was non-significantly longer than that of the dentine (20.80 months). Progressions of the initial enamel proximal caries were significantly different among primary molars at the average 18.3-month follow-up. The median survival period of the enamel proximal caries was more extended than that of dentine but without statistical difference. These results provide essential information for dentists regarding an appropriate appointment for bitewing examinations.

Pathway analysis between dental caries and oral health-related quality of life in the transition from childhood to adolescence: a 10-year cohort study.

To evaluate the direct and indirect pathways between cavitated carious lesionsand oral health-related quality of life (OHRQoL) during the transition from childhood to adolescence. A prospective cohort study followed an initial sample of 639 children (one to five years old), in southern Brazil for ten years. In addition to the baseline (T1), two subsequent reassessments were conducted after seven (T2) and ten years (T3). OHRQoL was measured through the Early Childhood Oral Health Impact Scale (ECOHIS) and Child Perceptions Questionnaire (CPQ8-10 and CPQ11-14), according to the age group. Dental caries was evaluated using the International Caries Detection and Assessment System (ICDAS) in the three waves. Socioeconomic variables and other factors related to oral health (frequency of toothbrushing and toothache) were also collected. Structural equation modeling was used to estimate the direct and indirect effects among the variables over ten years. A total of 449 and 429 children were reevaluated at T2 and T3 (positive response rates of 70.3% and 67.1%, respectively). Dental caries in T1 and T2 directly predicted the occurrence of a worse OHRQoL in the respective follow-up periods. Dental caries at T3 indirectly predicted a worse OHRQoL (T3), via toothache. Dental caries at T1 and T2 directly predicted the occurrence of dental caries at T3, while a worse OHRQoL at T2 directly predicted a worse OHRQoL at T3. Dental caries negatively impacts, directly and indirectly, the OHRQoL from early childhood to adolescence.

Examining the Efficacy of 38% Silver Diamine Fluoride in Halting Active Dental Caries Lesions Among Children: A Descriptive Study.

Dental caries, a prevalent issue among children, often leads to discomfort and potential complications. Utilizing caries-arresting treatments to slow down its progression offers a practical alternative. Previous research indicates that topical fluorides can deactivate and remineralize enamel caries. This study aims to evaluate the efficacy of 38% silver diamine fluoride (SDF) in halting active dental caries lesions in children. This descriptive case series was conducted at the Operative Dentistry Department of the Nishtar Institute of Dentistry in Multan, Pakistan. We enrolled 753 patients aged three to nine years, of both genders, each with at least one cavitated lesion graded 3-6 according to the International Caries Detection and Assessment System (ICDAS). SDF was directly applied to dried and isolated teeth using a micro brush and left to absorb for up to two minutes (adjusted based on the child's cooperation), and parents were instructed to ensure the child refrained from eating or drinking for an hour post-application. Baseline examinations were performed by consultant restorative dentists, and reexaminations were conducted after two to three weeks by a consultant unaware of the study. The study included children aged three to nine years, with a mean age of 6.02±1.35 years. The majority of patients (61.75%) were aged between three and six years. Among the 753 patients, 619 (82.20%) were male, and 134 (17.80%) were female, with a male-to-female ratio of 4.6:1. The efficacy of 38% SDF in arresting active dental caries lesions in children was observed in 720 (95.62%) patients. This study demonstrates that 38% SDF is highly effective in halting active dental caries lesions in children.

Assessment of severity and mineral composition of saliva in schoolchildren with molar-incisor hypomineralization (MIH).

The aim of the study was to evaluate the severity of molar incisor hypomineralisation (MIH), related oral health and investigate salivary mineral composition. The study was conducted with 50 participants aged between 6-15 years who were effected with MIH and 50 without MIH. The International Caries Detection and Assessment System (ICDAS) scores, Decayed, Missing, Filled Teeth/Surface (DMFT/S), dft/s and gingival/plaque indices were evaluated. The pH, flow rate, buffering capacity and mineral composition of saliva was measured. "Student t" test, one-way analysis of variance in repeated measurements of groups, and Tukey multiplex in subgroup comparisons was used. Kruskal-Wallis, Mann-Whitney U, Wilcoxon and chi-square tests were used to analyze qualitative data and compare groups. A total of 100 children (57 females 43 males, mean age 10.12 ± 1.85) participated in the study. There was no difference between ICDAS, DMFT/S scores, but dft/s index values were statistically significant (p = 0.001). The simplified oral hygiene index of MIH patients were statistically higher, but no significant differences were found in modified gingival indices (p = 0.52). Although the salivary pH and flow rate of the patients in the study group were lower, the buffering capacity was higher than those in the control group, but no significant difference was observed (p = 0.64). The mean values of phosphorus, carbon and calcium content in the saliva samples of MIH patients were higher than those of patients without MIH, and this difference was low for phosphorus (p = 0.76) and carbon (p = 0.74), but significantly higher for calcium. To the best of our knowledge, this is the first study to evaluate the association between calcium, phosphate and carbon levels in saliva of children with MIH. The significantly high amount of calcium in the saliva of patients with MIH suggests that further investigations are needed.

Comparison of Marginal Seal and Tensile Bond Strength of an Alkasite, Zircomer, and Bulk Fill Composite to Carious Affected Primary Molars

Assessment of the micro tensile bond strength (μTBS) and microleakage of contemporary restorative materials (Cention N cement (CN), Bulk-fill Resin-based composite (BF-RBC), and Zirconomer Improved) bonded to carious affected dentin (CAD) of primary molars as compared to conventional control Glass ionomer cement (GIC). Eighty human primary molars having scores 4 and 5 of the International Caries Detection and Assessment System (ICDAS) were included. Specimens were randomly allocated into four groups (n = 20) Group I = GIC, Group 2: Zirconomer Improved, Group 3: CN, and Group 4: BF-RBC. All the samples were thermocycled followed by marginal leakage, μTBS, and failure mode assessment using a dye penetration test, universal testing machine, and a stereomicroscope. The μTBS and microleakage results were examined using (ANOVA) and Tukey post hoc tests. Samples from Group 1 (GIC) revealed the highest value of marginal leakage (30.55±10.31 nm) and the lowest recorded value of μTBS (12.28±0.32 MPa). In contrast, the specimens from Group 3 (CN) demonstrated the lowest levels of microleakage (14.89±4.33 nm) and highest bond integrity (18.12±0.79 MPa). Cention N cement and Bulk-fill composite have shown to be reliable options as a restorative material in primary dentition due to their superior tensile bond strength and reduced marginal leakage scores when applied to caries-affected dentin.

Detection of Early Smooth Surface Caries in Primary Molars using Conventional Methods in a Low-Resource Setting: A Cross-sectional Study

Introduction: Dental caries is a widespread chronic disease that affects nearly 100% of adults in developing countries. Detecting caries early is crucial for effective remineralisation and improved prognosis. However, identifying smooth surface caries in its early stages remains challenging for many healthcare professionals globally due to the subjective nature of visual inspection. Aim: To determine the most effective method for detecting early smooth surface caries in limited resource settings. Materials and Methods:The present cross-sectional study was conducted in the Department of Pedodontics, Dr. R. Ahmed Dental College and Hospital (tertiary care centre), Kolkata, West Bengal, India, from March 2021 to August 2022. Study was conducted involving 120 primary molars from Bengali children aged 5 years and above. The teeth were randomly selected while adhering to specific inclusion and exclusion criteria. The occlusal and proximal surfaces of the teeth were assessed using three methods: unaided Visual Examination (VE), Magnifying Loupe (ML)-assisted VE, and the fluorescence-based DIAGNOdent pen (considered the gold standard). Two assessments were performed for each method, one before air-drying and another after air-drying. Caries detection followed the International Caries Detection and Assessment System (ICDAS) II clinical scoring system, and data analysis was conducted using the Chi-square test for proportions. Results: In the present study, there were 76 male children and 44 female children and the mean age of the children was 7±2.5 years. Unaided VE exhibited a diagnostic accuracy of 87.5% and 77.5% for air-dried and non air-dried tooth surfaces, respectively. ML-aided VE yielded a diagnostic accuracy of 88.34% and 85% for air-dried and non air-dried tooth surfaces, respectively. Conclusion: The present study concluded that even without the assistance of an ML, drying the tooth surface can achieve a level of caries detection accuracy comparable to that of MLaided VE.

Prevalence of Dental Caries in Permanent Second Molars in Teenagers Using ICDAS

Introduction: Dental caries is a chronic disease of the tooth which is represented by demineralisation and destruction of the organic matter of the tooth. Dental caries are versatile, capable of affecting the crown portion of the tooth initially, and may affect the unprotected root surfaces later on. International Caries Detection and Assessment System (ICDAS) provides a systematic approach of reviewing the available clinical dental caries to evaluate the development of dental caries&#x0D; Materials and Methods: This study is a single centered retrospective study in which the data was collected from a private dental college and hospital in Chennai, India. Patient details were collected from the hospital management system and a total of 1804 samples were collected. The data was tabulated using Excel and then statistically analysed using the latest version of SPSS software.&#x0D; Results and Discussion: The prevalence of ICDAS score 3 in second molars is higher in 17 year old patients with 2.88% in maxillary right second molars, 3.33% in maxillary left second molars, 3.55% in mandibular left second molars and 3.71% in mandibular right second molars. The prevalence of dental caries in permanent second molar is 9.34%. It is seen that ICDAS score 3 is 8.71% prevalent followed by ICDAS score 5 which is 0.63%.&#x0D; Conclusion: Within the limitations of the study, it was found that the prevalence of dental caries in permanent second molars is 9.34% with ICDAS score 3 being the most prevalent followed by ICDAS score 5 which is 0.63%.

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.

A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children.

The study evaluated the effectiveness of nanosilver fluoride (NSF) in arresting dental caries in 4-8-year-old school children. The two-arm, parallel-group randomized controlled trial included a total of 148 children aged 4-8 years with active carious lesions. Children were randomly divided into two groups: group I-NSF (n = 74); and group II-water (placebo and n = 74). Baseline data were recorded using the International Caries Detection and Assessment System (ICDAS) II criteria, and the teeth were treated with either of the solutions. Later, the teeth were evaluated by two blinded examiners for the lesion activity using ICDAS II criteria at 1, 3, and 6-month intervals. The obtained data were analyzed using the Chi-squared test for intergroup comparison and Cochran's Q test for intragroup comparison. Cohen's κ test was used to check the interexaminer and intraexaminer variability. Carious teeth treated with NSF have shown 56.3, 59.2, and 62% arrested carious lesions, whereas the placebo group has shown 0, 2.9, and 4.4% arrested lesions at 1, 3, and 6-month intervals, respectively. NSF showed a high statistically significant difference (p < 0.001) in arresting dental caries compared to the control group at all the time intervals. Nanosilver fluoride (NSF) is found to be effective in arresting dental caries without staining carious lesions. Therefore, it can be used to reduce the bacterial load for caries stabilization in the initial phase of the comprehensive treatment protocol for the management of children with active caries lesions. Most of the decayed teeth in the primary dentition remain untreated either because of inaccessible dental services or the uncooperativeness of children. Hence, there is an absolute need for a cariostatic agent which arrests the progression of caries in a simple and noninvasive manner. The results of this study evidence that NSF effectively arrests dental caries in primary teeth. Hence, this can be a very economical way of arresting caries in the population who don't have access to regular dental treatment. Devi C, Chandrasekhar R, Vinay C, et al. A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children. Int J Clin Pediatr Dent 2023;16(5):667-670.

The Effectiveness of Educational Mobile Messages on Prevention of Dental Caries in Group of Preschool Children

Purpose: To estimate the impact of providing mobile educational messages on prevention of dental caries in group of preschool children. Materials and methods: 100 high caries risk children aged between 3 and 5 years from both genders were randomly allocated into two groups (n=50) regarding to receiving educational messages: test group; included children whose parents received educational messages and control group; included children whose parents didn’t receive any messages. Every 14 days the test group received educational messages via Whats Application Messenger (WhatsApp). Visible plaque index (VPI), the decayed, missed, filled (dmf) and the International Caries Detection and Assessment System (ICDAS) indices were measured at the start of the study, 3-, 6- and 9-month follow-ups, whereas Health Literacy levels and dietary habits were determined by HEALS literacy questionnaire at the start of the study and 9-month follow-up. Results: Educational messages increased parental HEALS scores, enhancing children’s oral health and reducing the severity of dental caries. Conclusion: Mobile educational messages provided through WhatsApp were efficient in reducing dental caries among preschool children and enhancing health literacy of the parents.

Food Insecurity and Dental Caries in Rural Mexican Populations.

Food insecurity (FI) is a priority for government and health organizations. Over 95% of the world's population has a carious lesion or will develop one before death. This study evaluated the association between FI and oral health in two rural communities in Chiapas, Mexico. The study was conducted with patients attending an oral health campaign for dental checkups. Data were collected between April and August 2017 using the Latin-American and Caribbean Scale of Food Security (ELCSA) and the International Caries Detection and Assessment System (ICDAS). We included 209 participants from Siltepec and Huehuetan, Mexico; 67% were women. The results of the ELCSA were mild FI in 43% (n = 91), moderate FI in 22% (n = 45), and severe FI (n = 6) in 3%; 32% had food security. The ICDAS results were initial decay with a mean of 6.22, moderate decay with a mean of 1.81, and extensive decay with a mean of 1.77. FI is associated with dental caries, and food-insecure individuals have a higher probability of severe dental caries. In this study, the FI level was lower than in other rural populations in Mexico. Identifying these individuals and addressing the factors related to FI can be useful in the rural communities.

Comparison of teledentistry and on-site clinical diagnosis using the International Caries Detection and Assessment System (ICDAS) in Rawalpindi and Islamabad: a validation study

Dental caries significantly impact global health, particularly in Pakistan, where the prevalence is notably high. This study assessed the diagnostic accuracy of mobile teledentistry in Islamabad and Rawalpindi by employing the International Caries Detection and Assessment System (ICDAS) as a benchmark. This cross-sectional validation study was conducted from July to September 2022 in nine private dental clinics involving 460 participants proficient in basic Android smartphone functions. The diagnostic procedure comprised initial in-person evaluations by dentists, subsequent remote assessments using images captured by smartphones based on verbal instructions, and validations by a third independent dentist. Statistical analyses were performed using sensitivity, specificity, Matthew’s correlation coefficient, and receiver operating characteristic (ROC) curves. Teledentistry achieved a specificity of 89% and a sensitivity of 70%. The positive and negative predictive values were 74.6% and 86%, respectively. The ROC curve analysis, with an area under the curve greater than 0.7, confirmed the high diagnostic efficacy of the method. The Cohen’s kappa statistic reached 0.814, demonstrating substantial interrater reliability, while the diagnostic odds ratio was 18, indicating strong discriminative power. This study confirmed that teledentistry, enabled by the use of smartphone cameras, serves as a reliable method for detecting dental caries, with efficacy comparable to that of conventional clinical examination methods. It significantly extends dental care accessibility, particularly in geographically remote or economically underserved regions, effectively mitigating the logistical challenges associated with traditional dental visits. The findings support the broader implementation of teledentistry, highlighting its potential to enhance mass screening efforts, improve oral health outcomes, and alleviate pressures on healthcare systems across diverse demographic landscapes.

Knowledge and attitude of dentists toward minimally invasive caries management in Almadinah Almunawwarah province, KSA

ObjectiveOver time, the management of dental caries has shifted towards minimally invasive dentistry (MID) and more conservative and evidence-based strategies. Although most dental schools have begun to incorporate MID caries management strategies in their curriculum; it has yet to be established whether these strategies are being implemented in everyday practice. In this study, we aimed to evaluate the knowledge and attitude of dentists working in Almadinah Almunawwarah province in KSA with regards to the implementation of MID in caries management. MethodsThis was a cross-sectional study which involved sending a self-administered and anonymous questionnaire to dentists practicing in both private and public clinics in Almadinah Almunawwarah, KSA. The questionnaire consisted of four sections: demographic data, dental education, clinical experience, and knowledge and attitude with regards to MID and the management of caries. For statistical analysis, we calculated simple descriptive statistics, including mean and frequency distributions; comparisons were performed using the Chi-squared test. ResultsA total of 130 dentists participated in the study; the majority of respondents were Saudi general dentists working in private dental clinics; there was a similar distribution of males and females and the age of the dentists ranged from 25 to 35 years. With regards to knowledge relating to selective caries removal (SCR), only 20% of subjects responded that SCR is based on lesion depth, while 74.6% reported that carious dentin consistency is important for SCR. Although 60% of respondents reported that they would assess a patient's risk of caries before commencing treatment, only 11.5% would perform risk assessment and non-surgical treatment in the first visit for caries management. Only 4.6% reported that they used the International Caries Detection and Assessment System (ICDAS) II criteria for the diagnosis of caries while 46.2% used the G.V. Black criteria. In addition, 53.8% of participants agreed that caries must be completely removed to prevent the progression of caries. ConclusionDentists in Almadinah Almunawwarah province had reasonable levels of knowledge regarding the importance of MID in caries management. However, they did not fully implement certain concepts, such as caries risk assessment and the recently recommended criteria for the diagnosis of caries, in their everyday clinical practice.

Carious status and socio-behavioral risk factors among 12 year-old children in South-Central region in Romania

BackgroundRegular screenings at children population level are necessary in order to assess communities’ need for education, prevention, as well as early detection and intervention programs The study aims to assess dental caries experience and oral health-related behaviors among Romania children from the South and Central region.MethodsThe cross-sectional study conducted in 2019–2020 is part of the national survey “Romanian Oral Health Survey”, under the endorsement of the World Health Organization (WHO). The stratified, randomized and representative sample included 98 children of 12 years of age. The assessment included a clinical examination, using International Caries Detection and Assessment System (ICDAS) and the Oral Health Questionnaire for Children recommended by the World Health Organization.ResultsResults revealed that the frequency of caries-free children among 12 year-olds was 36.7% and the mean DMFT was 2.89. Regarding the oral health-related habits, 38.8% of children brushed twice daily; the consumption of sugary foods multiple times per day has been frequently met and 11.2% at the age of 12 never visited the dental office.ConclusionsThe findings revealed that caries prevalence was high and behaviors negatively influence oral health. The presented data are of utmost importance for Romanian policy makers to promote oral health education among children, to support consistent preventive oral health campaigns and to stimulate dental attendance, irrespective of children’ living areas or gender.

Evaluation of the effects of different bracket types on the detection of interproximal enamel caries using periapical radiography

Aim: During orthodontic treatment, dental materials can affect the imaging of caries lesions. Material density and X-ray beam attenuation play important roles in this imaging. This study aims to evaluate the artifacts that are caused by brackets made of different materials and affect the visibility of International Caries Detection and Assessment System (ICDAS) code 5 caries. Methodology: One premolar tooth with ICDAS code 5 caries was examined. Eight periapical radiographs were taken: one without a bracket and seven with different types of brackets (composite with metal slot, self-ligating ceramic, monocrystalline ceramic, polycrystalline ceramic, zirconium, self-ligating stainless steel, and conventional stainless steel). The gray values of the caries region were evaluated using Fiji software (version 1.53f, National Institutes of Health, USA) on periapical radiographs. Results: Conventional stainless steel and self-ligating stainless steel brackets increased the radiopacity of the outer half of the enamel (E1). When these brackets were present, the gray values changed by -13.63633 (p = .026) and -16.38967 (p = .006), respectively. There was no statistically significant difference in column B due to the brackets. However, numerically, the gray value changes were similar to those in column A. Conclusion: Orthodontic brackets affect the evaluation of periapical images. Ceramic brackets provide more advantages than stainless steel brackets for radiographic imaging. How to cite this article: Karabiber G, Arsan B, Kocaer AF. Evaluation of the effects of different bracket types on the detection of interproximal enamel caries using periapical radiography. Int Dent Res 2023;13(2):83-89. https://doi.org/10.5577/idr.2023.vol13.no2.6 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Caries clusters at lesion-severity thresholds: A Sierra Leone case study.

Despite being almost entirely preventable, globally, dental caries is extremely prevalent. Moreover, dental caries will continue to present an even larger challenge for lower income countries, particularly those in the African context, as they transition to a more Western diet. Hence, epidemiological data providing insight into disease patterns and trends is critical to inform public health action. The purpose of this study was to examine dental caries clusters by caries detection threshold among 15-year-old adolescents in Sierra Leone, using data from the latest national survey, and to explore associated sociodemographic factors. This paper presents a secondary analysis of oral health data on 490 15-year-olds from the Sierra Leone national oral health survey of schoolchildren. Hierarchical cluster analysis of dental caries experience was conducted across all surfaces at four decay detection thresholds using the International Caries Detection and Assessment System (ICDAS) (clinical: ICDAS 2-6, cavitated: ICDAS 3-6, obvious: ICDAS 4-6 and extensive obvious: ICDAS 5-6 decay) across the four regions of Sierra Leone. Ordered logistic regression was used to estimate the association of sociodemographic factors with generated clusters relating to clinical and obvious decay experience. These are of both clinical and epidemiological relevance. A 3-cluster decay pattern representing a 'low' to 'high' decay experience distribution was observed under each decay detection threshold across surfaces. For clinical decay (including visual enamel caries), 28.8% had low, 55.1% medium and 15.9% high caries status. In the adjusted model, the only significant risk factor across obvious and clinical decay thresholds was region, with adolescents outside the Western region more likely to experience decay. This study suggests that adolescents in Sierra Leone fall into three distinct caries clusters: low, medium to high decay experience distribution, regardless of decay threshold. It reinforces the importance of recognizing dental caries detection thresholds and the use of contemporary epidemiological methodology. This suggests that adolescents outside the Western region are likely to have higher caries experience. The data also provides insight to the nature of adolescents in each cluster and should help to inform policy and planning of the integration of oral health into primary care and school systems.