Proximal Surfaces Research Articles

Evaluation of Microhardness and Microleakage of Class II Silorane-Based Composite Restorations Post-Photoactivation Silorane-Based Composite Restorations Post-Photoactivation Techniques Technique

Objectives: The purpose of this study was to evaluate effect of additional light curing on microhardness and microleakage at cervical third of class II silorane-based composite restorations. Methods: Class II cavities were prepared on the proximal surfaces of 20 human premolars. The specimens were randomly divided into two groups of 10. In both groups, class II cavities were restored incrementally (gingival, oblique buccal and oblique lingual) with silorane-based composite (Filtek P90) and cured (group1: occlusal curing; group 2: additional curing from buccal and lingual). The samples were immersed in 0.5% fuchsine and dye penetration was recorded at the four regions of the gingival floor. Also, Vickers hardness test was performed at a distance of 1 mm above the gingival margin. Data were statistically analyzed using ANOVA after the evaluation of normal data distribution with Kolmogorov–Smirnov test at the 0.05 level of significance. Results: The two photo activation methods significantly affected the hardness (p=0.005) and microleakage (p=0.045). Additional light curing increased Vickers hardness when compared to occlusal curing. Comparison of microleakage in different areas of the first group did not show any significant difference (p=0.240) but the differences were significant between the different areas of the second group (p=0.028). Additional light curing decreased dye penetration in the all depths. Only in the H3 and M3, curing technique showed a significant effect on the results. Conclusions: Additional light curing would cause in better hardness and less microleakage. Therefore it is suggested after initial occlusal curing.

When to intervene in the caries process? An expert Delphi consensus statement.

To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.

Diyot lazer uygulamasının kök yüzeyi karbon, kalsiyum ve fosfor seviyelerine etkisi: Bir SEM-EDX çalışması

Background:Preservation of the organic ingredients on the root surfaces during the periodontal therapy has been emphasized in the literature. SEM-EDX analysis is an accepted approach to evaluate organic and inorganic components on investigated samples in terms of carbon, calcium and phosphor levels. The aim of this study was to evaluate the effects of diode laser application with periodontal pocket decontamination energy setting to the organic content of intact root surfaces via SEM-EDX analysis.Methods: Each proximal root surfaces of the root surfaces of 10 teeth which were extracted due to orthodontic reasons were divided as test (n=20) and control (n=20) sites. Diode laser (810 nm) applications were done to the test sites of root surfaces. All specimens were analyzed using SEM-EDX with respect to carbon, calcium and phosphor levels.Results:Diode laser applied root surfaces exhibit significantly lower carbon levels comparing with control sites. Additionally, increased calcium and phosphor levels were detected in the test sites.Conclusions:Within the limitations of this study, it can be concluded that, diode laser applications may alter organic content of intact root surface. Further studies are required to elucidate potential effects of diode laser application to specific protein components on the root surfaces.Keywords: Diode laser, root surface, SEM-EDX, element levels

Prevalence of Early Childhood Caries in Children Aged 1 to 5 Years in the City of Quito, Ecuador

Background: Early childhood caries is an aggressive pathology that can destroy the teeth in a short time, reaching the proximal surfaces, causing discomfort, pain and affecting the dental pulp, causing premature loss of deciduous teeth. Objective: The purpose of this research is to determine the prevalence of early childhood caries in children aged 1 to 5 years of the Metropolitan District of Quito. Materials and Methods: This is a cross-sectional study including a sample of 557 children attending child care centers in Quito, Ecuador, between May and July 2018. The sample was evaluated clinically registering the data in a simplified dental file containing the odontogram and the result of decayed, lost and sealed teeth, according to the dmft index, as well as data such as age and gender. Data were tabulated and analyzed statistically by independent t-test. Results: The prevalence of early childhood caries was found to be 59.61%. Children affected by early childhood caries presented a mean age of 2.83 years, the ones suffered the most from this pathology were those of 2 years (35.54%), followed by those of 3 years (34.94%) and 4 years (22.5%). Boys presented more early childhood caries (53.92%) in relation to the girls (46.08%). Conclusion: The early childhood caries presented a prevalence of 59.61% and a general dmft index of medium level of severity according to the classification of the World Health Organization, in children from 1 to 5 years of age in Quito, Ecuador.

Swept-source optical coherence tomographic observation on prevalence and variations of cemento-enamel junction morphology.

To investigate the prevalence of different patterns of cemento-enamel junction (CEJ) morphology under swept-source optical coherence tomography (SS-OCT). One hundred extracted human teeth were used consisting of incisors, premolars, and molars. Each sample was observed for every 500μm circumferentially along CEJ and OCT images of the pattern were noted. Microscopic observations were done for the representative sample using confocal laser scanning microscope (CLSM) and transmission electron microscope (TEM). The OCT images exhibited four CEJ patterns: edge-to-edge (type I), exposed dentin (type II), cementum overlapping enamel (type III), and enamel overlapping cementum (type IV). The prevalence of CEJ patterns was further statistically considered for mesial, distal, buccal, and lingual surfaces. The real-time imaging by SS-OCT instantly determined CEJ morphology. CLSM and TEM observation revealed morphological features along CEJ, which corresponded to OCT images of CEJ anatomy. OCT results showed 56.8% of type I pattern predominantly found on proximal surfaces, followed by 36.5% of type II pattern on buccal and lingual surface, 6.4% of type III pattern, and 0.3% of type IV pattern. There was a significant difference in prevalence of CEJ patterns among different types of teeth, but there was no statistically significant difference among the four surfaces in each type of teeth. OCT is a non-invasive diagnostic tool to examine the CEJ patterns along the entire circumference. OCT observation revealed even minor dentin exposure that would need clinical and home procedures to prevent any symptoms.

Clinical-statistical Study on the Biomimetic Adhesion of Whole Ceramic Inlays

Currently, a new approach to restorative dentistry is possible, from biomimetic point of view, by using restorative materials with a natural tooth-like structure and very strong adhesion to the hard remaining tissues. The objective of the study was to compare in vitro the marginal adaptation of restorations with whole ceramic inlays, using the biomimetic method compared to the classical method. A batch of 60 extracted impacted molars was used for the study. Large cavities were prepared at occlusal proximal surfaces according to minimally invasive therapy principles. The teeth were divided into 4 study groups (A, B, C, D). Batches A and C contain teeth prepared and restored through classical method, with entirely ceramic inlays. Batches B and D contain teeth restored through biomimetic adhesive method. After preparation, fluid composite (Gradia Direct Flo - GC) was used as a basic filling material to seal dentine wounds and dental canaliculi according to biomimetic principles. Cementing was done with Variolink Esthetic DC-Ivoclar (lot A and B) and with Maxcem Elite - Kerr (lot C and D). Samples were cut and prepared for microscopic analysis. The analysis of the four batches revealed the existence of the microfissure in the dentine wounds and the presence of fragments detached from the cementing material layer. The hybrid layer is homogeneous with qualitative dental canaliculi sealing. The difference between the two methods is the size of these defects, in the case of the classical method being approximately 2 times larger. The difference between the two types of cementing material used is due to the fact that in case of Maxcem Elite - Kerr cement, discontinuities have been observed at the level of cementing material - inlay material interface. The biomimetic method is superior to the classical one, the integrity of the layers of materials used in the biomimetic treatment is clearly superior to the integrity of the layers of material used in the classical treatment.

Caries Increment and Oral Hygiene Changes in 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Follow-Up Report Using ICDAS II and RADKE Criteria.

Objectives The purpose of this study was to investigate the caries increment and oral hygiene changes over a 3-year period and also compare the sensitivity and specificity of Radke’s caries assessment method to ICDAS II among 6- and 12-year-old children in Riga, Latvia. Materials and Methods Thirty-eight 6 and thirty-nine 12-year-old children were examined visually and with bitewing (BW) radiographs for dental caries at baseline and after a 3-year period. Decayed, missing, and filled surfaces (dmfs/DMFS) in all teeth were scored by one calibrated examiner using the Radke’s caries scoring criteria. Oral hygiene level was determined using Green-Vermillion index (G-V ind.) at baseline and after 3 years. ICDAS II was used to assess all children only at the 3rd-year time point. The parents of the 6- and 12-year-old children responded to a questionnaire on oral hygiene at baseline and at the 3-year mark. Statistical Analysis The data were analyzed using t -test, Chi-square test, Wilcoxon test (α= 0.05), and sensitivity and specificity tests. Results The mean (SD) values of G–V ind. and caries experience at baseline/3-year period in 6- versus 12-year-old children were as follows. G-V ind.: 1.14(0.80) /1.48(0.89) [ p = 0.4768] versus 0.99(0.45)/1.45(1.22) [ p = 0.0337]. DMFS: 0.72(1.02)/ 3.13(3.13) [ p = 0.0000] versus 6.79(5.14)/14.79(9.86)[ p = 0.0000]; dmfs: 11.26(8.71)/7.74 (4.86) [ p = 0.0780] versus 3.57 (2.03)/1.5(0.71)[ p = 0.3173].The sensitivity and specificity of Radke to ICDAS II of caries-affected surfaces was: in proximal surfaces–0.57 and 0.98, on occlusal surfaces–0.83 and 0.98, on buccal/lingual surfaces–0.43 and 0.99. Conclusions The result of the present study suggests that the increased caries experience over a 3-year period among the 6- and 12-year-old children in Riga may be due to the concurrent decreased level of oral hygiene, suggesting that ICDAS II instead of Radke’s criteria should be used to detect and monitor dental caries.

Delayed Photoluminescence in Metal-Conjugated Fluorophores.

Assemblies of metal nanostructures and fluorescent molecules represent a promising platform for the development of biosensing and near-field imaging applications. Typically, the interaction of molecular fluorophores with surface plasmons in metals results in either quenching or enhancement of the dye excitation energy. Here, we demonstrate that fluorescent molecules can also engage in a reversible energy transfer (ET) with proximal metal surfaces, during which quenching of the dye emission via the energy transfer to localized surface plasmons can trigger delayed ET from metal back to the fluorescent molecule. The resulting two-step process leads to the sustained delayed photoluminescence (PL) in metal-conjugated fluorophores, as was demonstrated here through the observation of increased PL lifetime in assemblies of Au nanoparticles and organic dyes (Alexa 488, Cy3.5, and Cy5). The observed enhancement of the PL lifetime in metal-conjugated fluorophores was corroborated by theoretical calculations based on the reverse ET model, suggesting that these processes could be ubiquitous in many other dye-metal assemblies.

The impact of oral hygiene, the intensity and increase of caries on the condition of Equia Fil glass ionomer and Tetric EvoCeram composite proximal restorations in permanent teeth

Introduction. Glass-ionomer cements and composite materials are widely used for direct restoration of carious lesions, also in young permanent teeth. However, knowledge on the effects of cariogenic factors on the quality of restorations performed using these materials, especially those covering proximal surfaces, which are more often exposed to bacterial plaque, is insufficient. Aim. The aim of the study was to assess the impact of oral hygiene and increased intensity of caries on proximal composite and glass ionomer restorations in young permanent teeth after 2 years of usage. Material and methods. Equia Fil glass-ionomer and Tetric EvoCeram composite restorations were performed in patients aged between 12 and 20 years with proximal carious lesions in premolars and molars. The clinical condition of restorations was assessed and indices such as OHI-S and D1-2DMFT (along with their increased values) were calculated at baseline, as well as during follow-up visits at 6, 12, 18 and 24 months. Correlations between clinical assessment of restorations and indices for oral hygiene and caries intensity, their increase and increased number of teeth with carious spots were evaluated. The study was approved by the Bioethics Committee of the Medical University of Warsaw (No. KB/157/2013). Results. A total of 100 proximal restorations were performed in 49 patients. After 24 months, 98 restorations (50 Equia Fil and 48 Tetric EvoCeram) were evaluated. Mean baseline OHI-S and D1-2DMFT were 1.37 and 12.04, respectively, for Equia Fil restorations, and 1.27 and 10.38 for Tetric restorations, with the following values reported during follow-up: 1.80 and 15.4; 1.63 and 12.38. Statistically significant relationships were found between OHI-S and values describing the state of materials. These values increased with increasing OHI-S and D1-2DMFT. Conclusions. Both Tetric Evo Ceram and Equia Fil restorations are susceptible to cariogenic factors.

Five new species of Acanthobothrium (Cestoda: Onchoproteocephalidea) from the long-tailed butterfly ray, Gymnura cf. poecilura (Elasmobranchii: Gymnuridae), from the Persian Gulf and Gulf of Oman.

Five new species of Acanthobothrium Blanchard, 1848 are described from Gymnura cf. poecilura from the Gulf of Oman and Persian Gulf. They all belong to the Category 1 and can be differentiated from all congeners by a combination of characters, including marginal lappets on the bothridial rim, the lack of spinitrich microtriches on the proximal bothridial surfaces, the position of the genital pore in the posterior one fifth of the proglottid, the direction of the cirrus sac parallel and clinging to the ovarian lobe, the lack of post-vaginal testes, and the interruption of the vitelline follicles by the ovary. The five new species are morphologically similar to each other but differ among each other in their cephalic peduncle length, proglottid and testes number, and the apolysis status. The most similar species to this new group is Acanthobothrium fogeli Gloldstein, 1964 from the Gulf of Mexico. The new species differ from A. fogeli by the muscular pad size, cephalic peduncle length and having marginal lappets on the bothridial rim. the species of Acanthobothrium occurs in three families of elasmobranchs in the Gulf of Oman and Persian Gulf (Dasyatidae, Rhynchobatidae and Gymnuridae). The true identity of many hosts in the region is ambiguous. Therefore, we designated the sampled elasmobranch as G cf. poecilura in accordance to the previously molecular study on a few individuals from the region.

Assessment of Near-Infrared (780nm) Light Transillumination Accuracy for Detection of Incipient Caries Lesions

The aim of study was to evaluate the accuracy of the near-infrared light transillumination technique used in the detection of the proximal incipient dental caries. The study was performed on 12 medium caries risk subjects (mean age of 26.5). A total number of 312 proximal dental surfaces from the posterior dental group were included in the study. All the proximal surfaces, which had not been restored, or unaffected by cavitated dental caries, were assessed by a near-infrared transillumination camera system using light with a 780nm wavelength (DIAGNOcam, KaVO). Bitewing radiographies were performed for all patients included in study. Visual and tactile examination after tooth separation was performed as gold standard to detect the incipient proximal dental caries (ICDAS scores 02 and 03). Statistical analysis using Chi-square test was performed to compare the diagnostic performance of near-infrared light transillumination and the bitewing radiography. Near-infrared light transillumination showed higher sensitivity (81.80%) when compared to bitewing radiography (65.90%) to detect the non-cavitated proximal enamel caries (ICDAS score 02). Near-infrared light transillumination method showed higher sensitivity (100%) when compared to bitewing radiography (81.50%) to detect the incipient cavitated proximal enamel caries (ICDAS score 03). Specificity values for proximal incipient dental caries (ICDAS codes 02 and 03) were 95.03% for near-infrared light transillumination and 99.18% for bitewing radiography. DIAGNOcam (KaVO) is a reliable tool with high diagnostic accuracy of the incipient dental caries localized on proximal surfaces of the posterior dental group.

Enamel protection after stripping procedures: An in vivo study

Interproximal enamel reduction (IPR) is a clinical procedure that has been in use since the advent of non-extraction orthodontic techniques. However, such a procedure affects the surface condition of the enamel and may predispose patients to cavities and hypersensitivity. The use of a remineralizing agent is recommended to prevent these side effects. The objective of our study was to evaluate the evolution of stripped proximal dental surfaces after exposure to the oral environment for 4 months with and without fluoride protection. Our sample consisted of 14 premolars (PM) from 6 patients of the Dentofacial Orthopaedics Department of the Consultation and Dental Treatment Centre of Rabat (CDTC) who required orthodontic treatment with PM extraction and had given their informed consent. The teeth were divided into 5 groups: group 1: intact enamel; group 2: intact enamel+fluoride varnish+4-month oral exposure; group 3: IPR (manual and mechanized)+extraction; group 4: IPR (manual and mechanized) without varnish+4-month oral exposure; group 5: IPR (manual and mechanized)+fluoride varnish+4-month oral exposure. Proximal surfaces were subjected to qualitative analysis by scanning electron microscopy and quantitative analysis by Dispersive Energy Spectroscopy (DES) to quantify the percentage of mineral elements. Exposure of stripped dental surfaces to the oral environment for 4 months with or without fluoride protection showed the persistence of surface irregularities caused by stripping. We noted an improvement in the percentage of mineral elements for both groups with and without fluoride protection. However, the percentages of calcium (Ca) and phosphorus (P) were close to that of intact enamel in the fluoride varnish group. Protecting stripped surfaces with fluoride varnish could help preserve the integrity of the enamel surface by restoring some of the mineral elements lost during stripping.

The effect varied scanning electron microscopy desiccation techniques has on demineralized dentin

The study objective was to assess (a) the effect of a rubbing-application of ethylenediaminetetraacetic acid (EDTA) or citric acid (CA) has on the ultrastructure of surface dentin and (b) the effect of two scanning electron microscopy (SEM) desiccation preparation techniques have on the collagen surface produced. Treatment regions on proximal root surfaces of extracted human teeth were root planned to expose dentin. Cotton pellets soaked in either 30% CA or 24% EDTA solution were rubbed on the treatment region then processed for SEM using one of two desiccation techniques, that is, (a) critically point dried from liquid CO2 (control) or (b) air-dried from tetramethylsilane (experimental). Specimens were coated with gold/palladium and viewed/photographed with an SEM. Specimens of the control groups displayed tufted fibrils (CA > EDTA) with many dentin tubules being partially obscured by overhanging fibrils. Air-dried specimens of both treatment groups displayed a flat intact monolayer devoid of a matted meshwork of fibrous collagen. Discrete fibril "sprigs," emanating from the surface monolayer, were characteristic of the EDTA group only. The rubbing-application of EDTA on dentin produces a tufted fibril surface somewhat similar to that produced by CA. Air-drying desiccation of both resulted in marked distortion with fibril collapse/coalescence of the tufted collagen matrix.

In vivo enamel stripping: A macroscopic and microscopic analytical study

Interdental stripping is often used in orthodontics to correct discrepancies of tooth shape or size. However, this procedure involves significant risks for the enamel. The roughness of the enamel surface might depend on the instruments used; it can lead to the accumulation of cariogenic plaque and periodontal problems. The main objective of our study was to evaluate the enamel surface condition after interproximal stripping in the mouth, by comparing different manual and mechanized enamel reduction protocols; on the other hand, the topography of the stripped area was observed to specify its location on the stripped proximal surfaces. An in vivo study was carried out: interdental stripping was performed in the mouths of patients undergoing orthodontic treatment and on healthy teeth intended for extraction for orthodontic or periodontal reasons. The sample was divided into four groups: in group 1, the distal faces were stripped with conventional single-sided diamond abrasive strips and non-stripped mesial faces (control faces); in group 2: the distal faces were stripped with the manual ContacEZ IRP Kit (single-sided abrasive files of different grain sizes) and non-stripped mesial faces (control faces); in group 3: the faces were stripped with ContacEZ IRP diamond discs attached to a handpiece and the mesial faces were not stripped (control faces); in group 4: the distal faces were stripped with the Intensiv Ortho-Strips mechanized system and the mesial faces were not stripped (control faces). Our study showed that regardless of the type of stripping material used, the enamel surface showed some roughness with the presence of striations and grooves of different widths and depths. Our observations objectivised more regular and less roughened enamel surface conditions when using the Intensiv oscillating files. Manual instruments (abrasive strips and files) have shown rougher and more irregular surface conditions that may constitute a real risk of carious and periodontal disease. The macroscopic evaluation of the topography of the stripped area showed that there is great variability in the situation and extent of the stripped area in relation to several parameters. The current mechanized instruments (oscillating files) provide enamel stripping with more comfort for the patient and the practitioner, and seem to produce a more regular and less harmful surface condition for the tooth and periodontium.

A Comparison of Friction Measurements of Intact Articular Cartilage in Contact with Cartilage, Glass, and Metal

The goal of this study was to develop a method of friction testing utilizing cartilage counter surfaces with a complete subchondral bone plate and compare the results to the cartilage on glass and metal (steel) counter surfaces. Articular cartilage surfaces with the underlying subchondral bone intact were not isolated through plug removal. Friction testing was completed using a tribometer (n=16). The coefficient of friction (COF) was measured between the proximal articular surfaces of the second carpal bone when brought into contact with the articular surface of the distal radial facet. The COF of the distal radial facet was obtained with glass and metal counter surfaces. Cartilage-cartilage interfaces yielded the lowest COF when a normal force of 5N and 10N was applied. No statistically significant increase in COF was noted for any combination when an increased normal force was applied (10N), although an increase was observed when glass and metal was in contact with cartilage. COF significantly increased when comparing the cartilage counter surface to metal under an applied load of 5N (p=0.0002). When a 10N load was applied, a significant increase in the COF was observed when comparing the cartilage counter surface to both the glass and metal counter surfaces (p=0.0123 and p < 0.0001 respectively). Results have shown that the described methodology was accurate, repeatable, and emulates physiologic conditions when determining the friction coefficient. The determined COF of cartilage against cartilage is significantly lower than cartilage against metal or glass.

Non-surgical Periodontal Therapy With Adjunctive Topical Metronidazole + Piroxicam Gel Compared With Piroxicam Gel in the Treatment of Chronic Periodontitis

Background: Host modulation therapy represents a treatment concept in which drug therapies are applied as an adjunctive therapy to conventional periodontal treatments to counteract the destructive effects of the host inflammatory response. Methods: This is a randomized split-mouth clinical trial in which a total of 40 outpatients diagnosed with mild-moderate chronic periodontitis with at least two pairs of contralateral anatomically matching proximal tooth surfaces showing probing depth of ≥5 mm were enrolled. Full-mouth scaling and root planing (SRP) was performed for all patients and pockets larger than 5 mm were selected for application of the studied gels. The selected sites were randomly divided into group A (piroxicam + metronidazole) and group B (piroxicam). Recall appointments were scheduled every two weeks within 3 months. The periodontal parameters, assessed in the molar teeth, also recorded that changes in clinical parameters during the study. Results: A total of 34 patients, with mean age of 45.2±8.6 (range 32-60) years, none of whom developed unpleasant side effect, were enrolled. Plaque index was significantly higher in group A; further it was a statistically significant difference in Bleeding on probing levels in group A at the baseline to last interval recall while current study. The results exhibited significant reductions in pocket depth within 3 months when compared to the baseline values, while the combination adjunctive therapy was more effective to reduce pocket depth. Furthermore, both groups showed a statistically significant mean reduction in clinical attachment level (CAL), but in the test group A had a higher CAL gain than in the control group B (P=0.039). Conclusions: The use of a combination of drugs can help reduce the clinical signs of periodontal disease, therefore, by changing the patient’s health habits along with periodontal treatment, the mechanical treatment that a microbial plaque can be obtained, and then the use of piroxicam + metronidazole gel as a complementary therapy, the recovery process can be accelerated.

Evaluation of Remaining Cementum Thickness Following the Use of Hand and Ultrasonic Curettes of Periodontally Diseased Root Surface - An in-vitro Study

Background: Scaling and root planing are the most predictable treatment outcomes for periodontal disease. However root planing with hand curettes removes excess of cementum as compared to ultrasonic curettes. Hence the purpose of this study was to evaluate the effectiveness of remaining cementum thickness following the use of ultrasonic and hand curettes. Aim: To evaluate the remaining cemental thickness following the use of hand and ultrasonic curettes on periodontally diseased root surface using a stereomicroscope. Materials and Methods: Thirty single rooted teeth were extracted due to advanced periodontitis and were randomly divided into two groups: Group 1 (SRP with hand curettes) and Group 2 (SRP with ultrasonic curettes). The proximal surfaces of the teeth (mesial and distal) were subjected to root planning. one surface served as a test site where instrumentation was done and no instrumentation was done on the other surface (control site). Following instrumentation, midroot region of instrumented specimen was cross-sectioned and prepared for stereomicroscopic study. The data gathered from stereomicroscopic study was subjected to statistical analysis by Mann Whitney test. Results: The results of our study showed that in both the groups, the mean cemental thickness in scaled group was significantly lower than unscaled group. Clinically, teeth treated with the ultrasonic scaler showed less tooth substance removal than hand curettes but the difference between the two groups were statistically non-significant. Conclusion: Both the therapies i.e. SRP with hand curettes and ultrasonic curettes seemed to be effective in the removal of diseased cementum.

Comparison of retention of two proximal sealants in mandibular first molars of 12-year-old school children - A split-mouth randomized trial

Aim: This study was done to assess and compare the retention properties of a proximal sealant made of polyurethane dimethacrylate and a resin-based adhesive system for sealing proximal surfaces of permanent mandibular first molars in 12-year-old children over a period of 6 months. Methodology: A split-mouth randomized trial was conducted among 50 school children. Pre-operative and post-operative bitewing radiographs were taken bilaterally prior at baseline and the end of the sixth month. Separators were placed for those children who did not have physiological spacing. The interventions were delivered on the left and right sides after randomization as per the manufacturer’s instructions, and post-operative instructions were given to the participants. The interventions were assessed for retention primarily and other criteria such as color match, marginal discoloration, marginal adaptation, anatomic form, caries formation (using bitewing radiographs), post-operative sensitivity, and surface roughness at the end of the 1st, 3rd, and 6 months using United States Public Health Service Modified Ryge Criteria for Direct Clinical Evaluation of Restorations proposed by Cvar and Ryge, 1980. The data were compiled, analyzed using SPSS and results were generated. Conclusions: The study results revealed that the resin-based adhesive system was better than the adhesive patch in terms of retention over a period of 6 months. Hence, the feasibility of including proximal sealants as a part of the preventive regimen for caries risk children should be positively considered.

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.

Near-infrared multispectral endoscopic imaging of deep artificial interproximal lesions in extracted teeth.

A safer alternative method to radiographic imaging is needed. We present a multispectral near-infrared scanning fiber endoscope (nirSFE) for dental imaging which is designed to be the smallest imaging probe with near-infrared (NIR) imaging (1200-2000 nm). The prototype nirSFE is designed for wide-field forward viewing of scanned laser illumination at 1310, 1460, or 1550 nm. Artificial lesions with varying sizes and locations were prepared on proximal surfaces of extracted human teeth to examine capability and limitation of this new dental imaging modality. Nineteen artificial interproximal lesions and several natural occlusal lesions on extracted teeth were imaged with nirSFE, OCT, and microCT. Our nirSFE system has a flexible shaft as well as a probe tip with diameter of 1.6 mm and a rigid length of 9 mm. The small form factor and multispectral NIR imaging capability enables multiple viewing angles and reliable detection of lesions that can extend into the dentin. Among nineteen artificial interproximal lesions, the nirSFE reflectance imaging operating at 1460-nm and OCT operating at 1310-nm scanned illumination exhibited high sensitivity for interproximal lesions that were closer to occlusal surface. Diagnosis from a non-blinded trained user by looking at real-time occlusal-side nirSFE videos indicate true positive rate of 78.9%. There were no false positives. This study demonstrates that nirSFE may be used for detecting occlusal lesions and interproximal lesions located less than 4 mm under the occlusal surface. Major advantages of this imaging system include multiple viewing angles due to flexibility and small form factor, as well as the ability to capture real-time video. The multispectral nirSFE has the potential to be employed as a low-cost dental camera for detecting dental lesions without exposure to ionizing radiation. Lasers Surg. Med. 51:459-465, 2019. © 2019 Wiley Periodicals, Inc.