Preparation of a polypeptide fluorescent probe based on aggregation induced luminescence and its application in the detection of early dental caries / 国际生物医学工程杂志

Objective:To prepare a peptide fluorescent probe based on aggregation-induced emission and to investigate its application in the detection of early caries.Methods:Eight aspartate-serine-serine (DSS) were combined with aggregation-induced emission material to prepare peptide fluorescent probes, and an artificial demineralization model was established in vitro. The samples were immersed in the peptide fluorescent probe solution for 1 min, and a fluorescence imaging system was applied to examine the tooth samples and collect images and fluorescence data. Scanning electron microscopy was also applied to observe the phenotype of the teeth, and electron microscopy was applied to detect the calcium-phosphorus ratio on the enamel surface of the teeth. Polarized light microscopy was also applied to observe the enamel area of the teeth. Results:The fluorescence intensity of demineralized teeth was clearly observed to be lower than that of normal teeth in the peptide fluorescent probe-treated area, and the difference was statistically significant ( P < 0.05). The results of scanning electron microscopy showed that the enamel surface of the demineralized group had more irregular pores, while the enamel surface of the undemineralized group was flatter with only some irregular accumulation of flakes. The results of polarized light microscopy showed that a clear birefringence could be observed in the enamel region of normal teeth, while a black area or the disappearance of the birefringence effect accompanied by a partial black dark shadow could be observed in the enamel region of demineralized teeth. Conclusions:An aggregation-induced luminescence-based peptide fluorescent probe was successfully prepared, which can precisely localize the enamel and show some application value in early caries detection.

Comparative Evaluation of ICDAS, WHO and Histological Examination in Detection of Occlusal Carious Lesions / Avaliação comparativa de ICDAS, OMS e Exame histológico na detecção de lesões cariosas oclusais

A detecção de lesões cariosas oclusais através de sistemas de pontuação visual está em contínua validação com a profundidade histológica do processo de desminerização da cárie. Objetivo: O presente estudo teve como objetivo comparar o Sistema Internacional de Detecção e Avaliação de Cáries (ICDAS), o Sistema da Organização Mundial da Saúde (OMS) e o exame histológico na detecção de lesões cariosas oclusais. Material e Métodos: 20 pré-molares foram avaliados por exame visual ICDAS, OMS e exame histológico usando estereomicroscópio (SM) para a detecção de cárie oclusal. As superfícies oclusais foram avaliadas por dois examinadores, e todos os dentes foram avaliados visualmente e histologicamente. Resultados: Para cada um dos três sistemas, foi realizada uma análise do coeficiente de correlação interclasses, sendo que a diferença entre os três sistemas de detecção de cárie oclusal foi mínimo. O exame visual através da OMS registrou o maior coeficiente de intercorrelação seguido pelo sistema ICDAS, em seguida, o exame histológico, respectivamente. Conclusão: OMS e ICDAS demonstraram reprodutibilidade e precisão diagnóstica quando comparado com o exame histológico para detecção de cáries oclusais (AU)

Detection of occlusal carious lesions with visual scoring systems is in a continuous validation with the histological depth of carious demineralization. Objective: The present study aimed to compare the International Caries Detection and Assessment System (ICDAS), the World Health Organization (WHO) system and histological examination in detecting occlusal carious lesions. Material and Methods: 20 premolars were evaluated by visual examination using ICDAS, WHO and histological examination using stereomicroscope (SM) for occlusal caries detection. Occlusal surfaces were evaluated by two examiners then all teeth were visually and histologically assessed. Results: For each of three systems the inter class correlation coefficient was examined, the differences between the three systems of occlusal caries detection were minimal. The visual examination through WHO recorded the higher intercorrelation coefficient followed by ICDAS system then histological examination respectively. Conclusion: WHO and ICDAS have demonstrated reproducibility and diagnostic accuracy when compared with histological examination for detecting occlusal caries. (AU)

Effect of different exposure times on caries detection and pixel value in a wireless digital system

Objectives: The aim of this study was to assess, using the CDR Wireless®, the effect of different exposure times on caries detection and pixel intensity values. Materials and Methods: Forty teeth were x-rayed using a Schick CDR Wireless sensor at eight different exposure times – 0.06, 0.10, 0.13, 0.16, 0.20, 0.25, 0.30, and 0.32 s. Four observers evaluated the images for presence of carious lesions scoring proximal surfaces of each tooth on a 5-point scale. Scores were compared to histological sections of the teeth. Accuracy was evaluated by means of ROC curve analysis. Radiographs of an aluminum step wedge were obtained using the same eight exposure times. Pixel intensity measurements were obtained, and mean pixel values were statistically analyzed using linear regression. Results: The Az for each exposure time varied from 0.53 to 0.62. Two-way analysis of variance and Tukey test demonstrated that the exposure time of 0.25 s presented the best result and was significantly higher than 0.30 s and 0.35 s. In regard to mean pixel values, two different behaviors were observed, and the exposure time of 0.20 s presented mean pixel values in both phases. Conclusion: The performance of the exposure times from 0.06 s to 0.25 s was satisfactory for proximal caries detection, and 0.25 s is the best as indicated for this finality. Clinical Relevance: Considering that a reduction of exposure time represents a reduction of patient exposure dose, and this reduction cannot neglect image quality, the behavior of any digital system must be carefully evaluated.

Toma de decisiones para el tratamiento de caries oclusales en el sistema de salud público brasileño / Decision-making for the treatment of occlusal caries in the Brazilian public health system

ABSTRACT Introduction: Caries diagnosis errors have become a public health problem. Objective: Verify the consistency in terms of decision-making between Brazilian dentists from the country's public health system and the International Caries Detection and Assessment System (ICDAS), and evaluate the influence of professional experience on the management of the decay. Methods: There are 80 dentists in the public health service of Recife city, Brazil. All dentists were invited to participate in this cross-sectional study. Forty dentists agreed to answer questions about their decision-making in relation to the treatment of occlusal caries in low, moderate and high-risk caries situations. The time of clinical experience, the use of methods for the assessment of caries risk and the lesion activity were also inquired about. The T-test was applied with a significance level of 5 por ciento to compare the correlation between the International Caries Detection and Assessment System scores regarding the mean age of participants. Results: The disagreement between the dentists and the criteria used by the International Caries Detection and Assessment System for decision-making were mainly related to the sound surfaces or lesions restricted to the tooth enamel. It was thus verified that lack of consistency for the low-risk condition reached a score of 3 (32 percent), while moderate (95 percent) and high-risk (85 percent) conditions lay at a classification code of 0. The time of professional experience was not considered to have interfered with decision-making on any scale, regardless of the risk condition of the patient (p> 0.05). Conclusions: A divergence in terms of decision-making between dentists of the public health system and the International Caries Detection and Assessment System could be observed, specifically regarding sound surfaces or surfaces with lesions restricted to the tooth enamel. Furthermore, professional experience was seen as not influencing the management of caries(AU)

RESUMEN Introducción: Los errores de diagnóstico de caries se han convertido en un problema de salud pública. Objetivo: Verificar la concordancia de la toma de decisiones entre los dentistas brasileños del sistema de salud pública del país y el Sistema Internacional de Detección y Evaluación de Caries (ICDAS), así como evaluar la influencia de la experiencia profesional en el manejo de la caries. Métodos: De los 80 dentistas que existen en servicio público de salud en la ciudad de Recife, Brasil, todos fueron invitados a participar en este estudio transversal. Cuarenta dentistas acordaron responder sobre su toma de decisión en relación con el tratamiento de la caries oclusal en situaciones de caries de bajo, moderado y alto riesgo. El tiempo de experiencia clínica, el uso de métodos para la evaluación del riesgo de caries y la actividad de la lesión también fueron cuestionados. La prueba T, para un nivel de significancia del 5 por ciento, fue aplicada para comparar la correlación entre los escores del Sistema Internacional de Detección y Evaluación de Caries en relación con el promedio de edad de los participantes. Resultados: El desacuerdo entre los dentistas y los criterios utilizados por el ICDAS para la toma de decisiones se concentró en los códigos de clasificación que representan superficies sanas o lesiones restringidas al esmalte de los dientes. Se verificó así que la falta de consistencia para la condición de bajo riesgo se concentró en la puntuación de 3 (32 por ciento), mientras que las condiciones moderada (95 por ciento) y de alto riesgo (85 por ciento) se concentraron en los códigos de clasificación de 0. El factor tiempo de experiencia profesional no interfirió en la prevalencia de concordancia de la toma de decisión para cualquier escore, independientemente de la condición de riesgo del paciente (p> 0,05). Conclusiones: Se pudo observar una divergencia en cuanto a la toma de decisiones entre los dentistas del sistema de salud pública y el Sistema Internacional de Detección y Evaluación de Caries, específicamente con respecto a superficies sanas o superficies con lesiones restringidas al esmalte de los dientes. Además, la experiencia profesional no influyó en el manejo de la caries(AU)

Comparison of Diagnostic Validity between Laser Fluorescence Devices in Proximal Caries / 대한소아치과학회지

The aim of this study was to evaluate the proximal caries detecting ability and identify the optimal cut-off values of two types of laser fluorescence (LF) devices; classic type (DD) and pen type (DDpen).The number of proximal surfaces participated in this study were 164 surfaces in primary dentition and 438 surfaces in permanent dentition. Each tooth surface was sequentially assessed by two types of LF devices, and bitewing radiograph. The radiographs were classified into 3 groups in primary dentition (PR₀, PR₁, PR₂), and 4 groups in permanent dentition (PR₀, PR₁, PR₂, PR₃) according to the depth of caries, and used as gold standard.In primary dentition, the area under the curve (AUC) values of DD were 0.851 and 0.890, and those of DDpen were 0.883 and 0.917, respectively in enamel caries and dentin caries. In permanent dentition, the AUC values of DD were 0.762 and 0.886, and those of DDpen were 0.828 and 0.958, respectively in enamel caries and dentin caries.When detecting proximal caries in posterior teeth with LF devices, DDpen is more useful than DD in both primary and permanent dentition. However, in primary dentition, DD can also be useful to detect proximal caries.

Evaluation of a Caries Detecting Software System

he diagnostic accuracy of caries detecting software that assesses density in digital radiographs was questioned. Analysis of radiographs of extracted teeth using Logicon revealed a deviation in specificity for caries from visual examination of the teeth as well as from their radiographic images. Subsequent preparation of teeth similar to a clinical preparation for a restoration revealed a marked deviation from the Logicon analysis. Radiographic interpretation of early caries and resultant treatment decisions are a multifaceted complex process that is not simplified by desired but unreliable current computerized technique.

a precisión diagnóstica del software de detección de caries que evalúa la densidad en radiografías digitales fue evaluado. El análisis de radiografías de dientes extraídos utilizando Logicon reveló una desviación en la especificidad para la caries con respecto al examen visual de los dientes así como de sus imágenes radiográficas. La preparación subsiguiente de dientes similar a una preparación clínica para una restauración reveló una marcadadesviación del análisis Logicon. La Interpretación radiográfica de caries tempranas y su tratamiento son decisiones con un proceso complejo multifacético, el cual no es simplificado por la técnica computarizada.

Detection of proximal caries using quantitative light-induced fluorescence-digital and laser fluorescence: a comparative study

PURPOSE: The purpose of this study was to evaluate the in vitro validity of quantitative light-induced fluorescence-digital (QLF-D) and laser fluorescence (DIAGNOdent) for assessing proximal caries in extracted premolars, using digital radiography as reference method. MATERIALS AND METHODS: A total of 102 extracted premolars with similar lengths and shapes were used. A single operator conducted all the examinations using three different detection methods (bitewing radiography, QLF-D, and DIAGNOdent). The bitewing x-ray scale, QLF-D fluorescence loss (ΔF), and DIAGNOdent peak readings were compared and statistically analyzed. RESULTS: Each method showed an excellent reliability. The correlation coefficient between bitewing radiography and QLF-D, DIAGNOdent were −0.644 and 0.448, respectively, while the value between QLF-D and DIAGNOdent was −0.382. The kappa statistics for bitewing radiography and QLF-D had a higher diagnosis consensus than those for bitewing radiography and DIAGNOdent. The QLF-D was moderately to highly accurate (AUC = 0.753 – 0.908), while DIAGNOdent was moderately to less accurate (AUC = 0.622 – 0.784). All detection methods showed statistically significant correlation and high correlation between the bitewing radiography and QLF-D. CONCLUSION: QLF-D was found to be a valid and reliable alternative diagnostic method to digital bitewing radiography for in vitro detection of proximal caries.

Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T

Abstract The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.

Resumo O objetivo deste estudo foi descrever e comparar os achados sobre a prevalência e severidade da cárie dentária ao utilizar ICDAS e CPOD/ceod em um estudo epidemiológico com crianças e suas mães. Este estudo transversal avaliou 150 pré-escolares e suas mães. Os dados foram coletados utilizando-se o ICDAS e depois transformados em CPOD/ceod. Os códigos do ICDAS relacionados à cárie foram analisados de acordo com três diferentes pontos de corte: CP1 (0-hígido/1-6-cárie), CP2 (0-1 hígido/2-6-cárie) e CP3 (0-2 hígido/3-6-cárie), representando o D/d do índice CPOD/ceod. Os códigos do ICDAS referentes às restaurações, exceto selantes, foram considerados o O/o e o código 97 do ICDAS como o P/e do índice CPOD/ceod. A prevalência de cárie e sua severidade com o ICDAS foram de 92%, 84% e 31,3% em crianças e 97,3%, 96,6% e 80% em adultos de acordo com o CP1 / CP2 / CP3, respectivamente. Admitindo o ponto de corte CP3 como o padrão para a transformação de achados do ICDAS em CPOD/ceod, foi observado que o índice CPOD/ceod subestimaria 60% das lesões não cavitadas em crianças e 16,6% em adultos. O CPOD/ceod subestima a presença da doença ao desconsiderar as lesões não cavitadas na população pediátrica avaliada. A escolha de qual é o melhor índice para levantamentos epidemiológicos vai depender do propósito da pesquisa e da população-alvo: se o objetivo for estimar as necessidades da população para determinar cuidados clínicos em crianças e adultos, o CPOD/ceod pode ser suficiente. No entanto, se o objetivo for ter um diagnóstico mais abrangente da doença ao nível da população, a fim de desenvolver estratégias preventivas, para paralisar e reverter a doença, a detecção de lesões não cavitadas torna-se importante, principalmente em crianças pequenas.

In vitro performance of a pen-type laser fluorescence device and bitewing radiographs for approximal caries detection in permanent and primary teeth.

Aim: To evaluate the performance of a pen‑type laser fluorescence device (DIAGNOdent 2190; LFpen, KaVo, Germany) and bitewing radiographs (BW) for approximal caries detection in permanent and primary teeth. Materials and Methods: A total of 246 anterior approximal surfaces (102 permanent and 144 primary) were selected. Contact points were simulated using sound teeth. Two examiners assessed all approximal surfaces using LFpen and BW. The teeth were histologically assessed for the reference standard. Optimal cut‑off limits were calculated for LFpen for primary and permanent teeth. Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (Az) were calculated for D1 (enamel and dentin lesions) and D3 (dentin lesions) thresholds. The reproducibility was assessed by intraclass correlation coefficient (ICC) and Cohen’s weighted kappa values. Results: For permanent teeth, the LFpen cut‑off were 0–27 (sound), 28–33 (enamel caries) and >33 (dentin caries). For primary teeth, the LFpen cut‑off were 0–7 (sound), 8–32 (enamel caries) and >32 (dentin caries). The LFpen presented higher sensitivity values than BW for primary teeth (0.58 vs. 0.32 at D1 and 0.80 vs. 0.47 at D3) and permanent teeth (0.80 vs. 0.57 at D1 and 0.94 vs. 0.51 at D3). Specificity did not show a significant difference between the methods. Rank correlations with histology were 0.59 and 0.83 (LFpen) and 0.36 and 0.70 (BW) for primary and permanent teeth, respectively, considering all lesions. ICC values for LFpen were 0.71 (inter) and 0.86 (intra) for permanent teeth and 0.94 (inter) and 0.90/0.99 for primary teeth. Kappa values for BW were 0.69 (inter) and 0.68/0.90 (intra) for permanent teeth and 0.64 (inter) and 0.89/0.89 for primary teeth. Conclusion: LFpen presented better reproducibility for primary and permanent teeth and higher accuracy in detecting caries lesions at D1 threshold than BW for permanent teeth. LFpen should be used as an adjunct method for approximal caries detection.

Diagno Dent Laser Device : A R evolution In Caries Detection.

The diagnosis of dental caries is fundamental to the practice of dentistry. The accuracy of diagnosing "hidden" occlusal caries is recognized to be a challenge. These lesions are virtually impossible to detect using conventional methods. DIAGNOdent is a laser fluorescence device used for detecting caries. The main attraction of such a device is that it is able to identify signs of tooth decay earlier than traditional diagnostic methods. It utilizes laser light of a defined wavelength to help detect and quantify demineralized tooth substances without x-ray exposure. This revolutionary new device is easy to use and turns caries detection into a harmless, measurable, more reproducible and exacting procedure.

In vitro quantification of occlusal caries lesion using QLF-D, ICDAS, and DIAGNOdent / 대한구강보건학회지

OBJECTIVES: To compare the QLF-D method and the ICDAS and DIAGNOdent techniques for in vitro quantification of occlusal caries and to assess the histological features of the caries. METHODS: One hundred and twenty-two extracted permanent teeth were selected, and the site of interest on the occlusal surface was examined using each detection method. The occlusal sites were classified according to the ICDAS II criteria based on the decision taken by two investigators, who have taken the ICDAS E-learning course. The examined site was then measured using the DIAGNOdent, and the peak value was recorded. In addition, by using the QLF-D, the occlusal site was photographed to obtain the DeltaFmax value. After all assessments were performed, the occlusal sites were vertically sectioned in order to assess the histological features. This was considered the gold standard. The histological criteria were graded using a 4-point scale as follows: S=sound (n=21), E1=limited enamel caries (n=27), E2=caries extending to the dento-enamel junction (n=49), D=caries involving the dentine (n=25). RESULTS: An ICDAS code between 0 and 4 was assigned to all the occlusal sites, and this revealed the QLF-D value, which was between -95 to 0. The DIAGNOdent value was between 8 and 99. The correlation values of QLF-D, ICDAS, and DIAGNOdent with the histological features were 0.68, 0.58, and 0.46, respectively (P<0.01). A highly significant correlation was observed between QLF-D and the gold standard, which showed a moderate correlation and an acceptable correlation was observed with ICDAS (r=0.75, P<0.01). A statistically significant difference was observed in the average QLF-D values of each histological grade i.e., -28.5 (S), -53.7 (E1), -68.1 (E2), and -84.4 (D). CONCLUSIONS: The QLF-D showed a significant correlation with the ICDAS and histological features. Therefore, visual inspection with QLF-D would improve the detection accuracy and ensure early diagnosis of dental caries.

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

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