Quantification of sugar intake and mineralization of teeth in 13–15-year-old subjects – A pilot study

Background: Dental caries begins with the initiation of demineralization which is a reversible process. Diet, especially intake of sugar, is an important aetiological factor for demineralization of enamel which eventually leads to caries. Aim: This study aims to understand the quantitative relationship between sugar consumption and mineralization by finding out the change in mineralization of teeth as a result of the change in the sugar score. Settings and Design: This interventional study was done among 119 teeth of 19 subjects who were between the ages of 13–15 years in Hubli city. Materials and Methods: Sugar score was calculated from a 5-day diet history of the subjects and a DIAGNOdent pen was used to indicate the mineralization value of the teeth before the intervention. Diet counseling was given as an intervention after which sugar score and DIAGNOdent scores were measured again after 14 days and compared with the baseline values. Statistical Analysis: Descriptive statistics and a linear regression analysis was done to determine the relationship between the variables. Results: Sugar score and DIAGNOdent score after 14 days were found to have reduced significantly by 41.6% and 20.3% respectively from the baseline values. The Linear Regression indicated that a reduction of sugar score by 5 resulted in a decrease of DIAGNOdent score by 0.16. Conclusion: The findings of the present study suggest that the modification of sugar consumption brought about a significant improvement in the mineralization of the demineralized teeth thus making diet counseling an effective preventive strategy for caries prevention.

Effectiveness of Two Bioactive Restorative Materials in Dental Hard Tissues Remineralization as Indicated by Laser Fluorescence

Twenty extracted human sound premolars were selected and grouped into four groups and two class V cavity preparations, facial and lingual, were prepared at the cervical one-third of the crown of each tooth and extending into the root cementum to make a total of 40 cavities (n=10). The teeth were soaked in a demineralizing solution of pH 4.5 for 72 hours and a tooth surface conditioner was applied to remove remnants of the smear layer. Three laser fluorescence readings were recorded by DIAGNOdent pen for each cavity at enamel margin, dentin floor, and cementum margin. The groups were restored with four different restorative materials Cavit, temporary filling material (control), Ketac-Fil; a conventional glass-ionomer, and two bioactive restorative materials; Glass Carbomer and Biodentine. The restored teeth were stored in mineral water (37°C) for three weeks and brushed twice daily with Tooth Mousse toothpaste. The teeth were longitudinally cut into halves in the middle of the restorations and three DIAGNOdent pen readings were recorded at the same previous sites. Data were collected and statistically analyzed by one-way ANOVA and Tukey’s post-hoc-test at (p˂0.05). The results showed a significant increase in DIAGNOdent pen readings after soaking in the demineralizing solution in all tooth hard tissues, while a significant decrease was noted after the application of the restorations and storage in the three groups, other than control, indicating that both examined bioactive restorative materials were suitable for enhancing remineralization and subsequently arresting the three-tooth hard tissues carious lesions as the conventional glass-ionomer.

In Vitro Comparison of ICDAS And DIAGNOdent Pen in The Diagnosis and Treatment Decisions of Non-Cavitated Occlusal Caries / Comparación In Vitro de ICDAS y DIAGNOdent Pen en el diagnóstico y decisiones de tratamiento de la caries oclusal no cavitada

Abstract The aim of this study was to compare the efficacy of the ICDAS and the DIAGNOdent Pen in the diagnosis of occlusal caries lesions without cavitation, and for basing treatment decisions on the results obtained. Eighty permanent molar teeth that were healthy and non-cavitated or that had an initial occlusal lesion were evaluated. All teeth were investigated using DIAGNOdent Pen and ICDAS by four examiners. Histological evaluation of teeth was performed using stereomicroscopy by a histologist and different experienced dentist. For evaluation of the data, weighted kappa values (kw), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio (LR+) values of the tests were calculated. The diagnostic results obtained using the DIAGNOdent Pen were found to correlate better with the results obtained from histological sections than those obtained using ICDAS. When the treatment decisions of the observers depending on the results of ICDAS, and ICDAS and DIAGNOdent Pen combination were compared with the decisions made based on histological examinations, the decisions based on ICDAS and DIAGNOdent Pen combined (kw: 0.522) were more accurate than the ones based on ICDAS (kw: 0.415) alone. In conclution, professional experience is an effective factor in diagnosing occlusal caries lesions without cavitation with ICDAS and in making treatment decisions for them. DIAGNOdent Pen is sufficient in diagnosing occlusal caries lesions without cavitation.

Resumen El objetivo de este estudio fue comparar la eficacia de ICDAS y de DIAGNOdent Pen en el diagnóstico de lesiones de caries oclusales no cavitadas. Ochenta molares permanentes sanos y no cavitados fueron utilizados. Todos los dientes fueron investigados usando DIAGNOdent Pen e ICDAS por cuatro examinadores. La evaluación histológica de los dientes se realizó mediante estereomicroscopía por un histólogo y por un dentista con previa experiencia. Los resultados diagnósticos obtenidos con el DIAGNOdent Pen se correlacionan mejor con los resultados obtenidos a partir de las secciones histológicas cuando comparados a los obtenidos utilizando ICDAS. Las decisiones basadas en el uso combinado de ICDAS y DIAGNOdent Pen (kw: 0.522) fueron más precisas que los basados en ICDAS (kw: 0.415). En conclusión, la experiencia profesional es un factor eficaz en diagnóstico de lesiones de caries oclusal sin cavitación con ICDAS y en la toma de decisiones de tratamiento. DIAGNOdent Pen es una herramienta confiable para diagnosticar lesiones de caries oclusales sin cavitación.

Use of Lasers in Clinical Dentistry: A Review.

Improvements in technology have given the dentists many innovative treatment options. Dental Lasers are the most fascinating technologies in dental practice. Lasers offer many advantages over other conventional modalities of treatment; the laser treatment is now the modality of choice, in many dental applications. The emergence of lasers with variable wavelength and the ability to be used for various applications in dentistry have influenced the treatment and treatment planning of dental patients. It has become mandatory for practicing dentists to update themselves on lasers use in dentistry. This paper gives an overview of uses lasers in dentistry.

Comparación de la efectividad en la remineralización de la lesión inicial de caries dental utilizando dos protocolos de aplicación y dos marcas de flúor barniz al 5% / Comparison of the effectiveness in remineralizing the initial dental caries lesion using two application protocols and two brands of 5% fluoride varnish

Objetivo: Comparar la efectividad de dos protocolos de aplicación y dos marcas de flúor barniz al 5 % en la remineralización de la mancha blanca como lesión inicial de caries, en jóvenes entre 18 y 24 años de edad, alumnos de la Facultad de Odontología de la Universidad de El Salvador en el periodo de Agosto a Diciembre del año 2015. Metodología: La investigación es de tipo experimental, se realizó en 68 dientes con lesión inicial de caries dental (LIC). La muestra se distribuyó en dos grupos según protocolo a aplicar y cada grupo se subdividió en dos subgrupos según marca de barniz a aplicar. Se estableció el diagnóstico mediante criterios clínicos ICDAS (Sistema Internacional visual de Valoración y Detección de Caries Dental) y de fluorescencia Láser con Diagnodent® Pen, este utilizado también para evaluar la efectividad de las remineralizaciones obtenidas, los datos se recolectaron en una guía de observación, diseñada para registrar cada evaluación según el protocolo de aplicación establecido. Los resultados se analizaron con Prueba de Levene y T test estudio de pareo de significación e inferencia estadística empleando el software SPSS v.18. Resultados: En el transcurrir del tiempo el grado de desmineralización de los dientes tratados, disminuyó independientemente de la marca y del protocolo utilizado, no existiendo diferencia estadísticamente significativa, obteniendo una remineralización en el transcurso de tres meses de evaluación. En los seis controles realizados la Sig (p-valor) fue mayor a p= 0.05 evidenciando que no existe diferencia significativa entre las marcas. La prueba T, para el Control 4 fue de 0.01 para los dos protocolos, por lo tanto se asumen diferencias entre protocolos, en el Control 5 los resultados de la prueba T, fueron de 0.125, 0.127 en ambos protocolos, en el Control 6 la prueba T, fue 0.107, 0.108 en ambos protocolos, por tanto no hay diferencia entre los protocolos. Conclusiones: Los resultados estadísticos evidencian que no existe una diferencia significativa entre los dos protocolos de aplicación de flúor barniz y entre las dos marcas comerciales utilizadas.

Objective: To compare the effectiveness between two application protocols and two fluorine varnish brands at 5% in the process of white stain remineralization as initial caries lesion in dentistry students between18 and 24 years old from the Dentistry Faculty of the University of El Salvador in the period from August to December 2015. Methodology: The research was experimental. It was performed in 68 teeth pieces with initial cavity lesion (ICL). The sample was distributed in two groups according to the protocol to use and each group was subdivided in two subgroups depending on the varnish brand to apply. Diagnosis was stablished through ICDAS (International Caries Classification and Management System) criteria, and laser fluorescence, using Diagnodent® Pen. Laser fluorescence, which is also used to evaluate the effectiveness of remineralization obtained during the process. Data was collected in an observational guide designed to file each evaluation according to the application protocol stablished before. The results were analyzed with Levene and T Tests (matching signification and statistical inference study) using SPSS v.18 software. Results: Demineralization degree of treated teeth decrease regardless the brand and application protocol used with no statistical significant difference. The results showed that there was a remineralization process during the three-month period of the evaluation. On the six controls made the Sig (P-value) was higher than p=0.05 showing no statistical significant difference between the brands. In the fourth control, the T Test was 0.01 therefore it is assumed that there is difference between two protocols. In the fifth control, the results of the T test was 0.125, 0.127 in both protocols and in the sixth control the T test was 0.107, 0.108 in both protocols. Therefore, there is no difference between protocols. Conclusions: Statistical results showed that there is no significant difference between application protocols and commercial brands of varnish fluorine used.

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.

Efficacy Of Chemo- Mechanical Method (Carisolv ) of Caries Removal With That of Hand Cutting And Rotary Cutting Instruments.

Background and objectives : To evaluate the efficacy of chemo-mechanical method (carisolv) of caries removal with that of hand cutting and rotary cutting instruments with the help of knoop hardness measurements of the cavity floor. Method : The 45 carious molars were subjected to caries detector (Kavo DIAGNOdent) to assess the extent of the lesion before and after the study. The selected samples was divided into 4 groups of 15 teeth each. The first 3 groups were taken as study group Group I (Carisolv), Group II (Hand excavation), Group III (Carbide bur), and Group IV (Control). The treated cavities were cross-sectioned perpendicularly along the long axis of the tooth through the middle of the treated cavity and then subjected to knoop hardness test. Results : The knoop hardness of the remaining dentin thickness was least for group II (hand excavation) and highest excavation for control group IV (normal dentin), group I (carisolv) and group III (carbide bur) showed KHN values that was not statistically significant when compared to group IV. On comparing group I with group III the KHN of remaining dentin thickness of group III was more than group I but this was not statistically significant. Conclusion : It was thus concluded that group II (hand excavation) showed the least knoop hardness value and group I (carisolv) and group III (bur) showed similar to that of normal dentin although values of group III was more than group I but it was not statistically significant.

Efecto in vitro de las bebidas refrescantes sobre la mineralización de la superficie del esmalte dentario de piezas permanentes extraídas / In Vitro Effect of Refreshing Drinks on the Mineralization of Tooth Enamel Surface in Extracted Permanent Dental Pieces

El objetivo de este estudio fue determinar el efecto de las bebidas refrescantes sobre la mineralización de la superficie del esmalte de piezas dentarias permanentes extraídas. Para esto se realizó un estudio experimental donde la muestra correspondió a 50 cortes de premolares permanentes extraídos en estado íntegro, estos fueron distribuidos en tres grupos de estudio mediante asignación aleatoria: bebidas gaseosas, jugos y néctares, y aguas minerales purificadas y saborizadas más un grupo control. Los dientes fueron lavados y almacenados en saliva artificial a 4°C. A todos los cortes dentarios se les midió la mineralización con el equipo Diagnodent 2095 (Kavo®) antes de iniciar la exposición, la cual correspondió a un minuto en el tipo de bebida según grupo, seguido por tres minutos en saliva artificial, ciclo que se repitió cinco veces en un tiempo de 20 minutos. Este procedimiento se realizó una vez al día, por un mes y para cada día se utilizaron nuevas bebidas refrescantes. Una vez finalizado se volvió a medir la mineralización para luego realizar las comparaciones entre grupos. El grupo de bebidas gaseosas provocó una mayor desmineralización en la superficie del esmalte dentario (p=0,000), seguido del grupo de jugos y néctares (p=0,000). El grupo de aguas minerales saborizadas y purificadas no provocaron efectos sobre la mineralización de la superficie del esmalte. Por lo tanto, sólo el grupo de gaseosas y jugos provocaron un efecto desmineralizador en la superficie del esmalte de las piezas dentarias, siendo la Coca-cola la que produjo mayor efecto seguido de la Coca-cola light y luego el Kapo.

The aim of this study was to determine the effect of refreshing drinks on the mineralization of tooth enamel surface in extracted permanent dental pieces. For this an experimental study was conducted where the sample was composed by 50 permanent premolars extracted as an entire piece. These pieces were randomly distributed in three study groups: soft drinks, juices and nectars, and purified and flavored mineral waters, in addition to a control group. The teeth were carefully washed and stored in artificial saliva at 4 C. Before starting the exposure to refreshing drinks, all dental slices were tested in order to measure their baseline mineralization using the Diagnodent 2095 equipment (Kavo®). The exposition consisted in one minute of contact with the drink corresponding to each group, followed of three minutes in artificial saliva. This cycle was repeated 5 times in 20 minutes time. This procedure was carried out once daily, for one month, and every day new refreshing drinks were used. Once the assay finished, the premolar mineralization was measured again, in order to make comparisons between groups. The soft drinks group caused the highest demineralization on the teeth enamel surface (p=0.000), followed by the juices and nectars group (p=0.000). In the purified and flavored mineral waters group, no effects were found on the mineralization of the enamel surface. A demineralizing effect on the enamel surface of dental pieces was observed only in the groups of soft drinks and juices, where Coca-Cola caused the highest effect, followed by Coca-Cola light and then Kapo.

Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - An in vitro study using scanning electron microscope and DIAGNOdent®.

Introduction: Remineralization as a treatment procedure has received a lot of attention both from clinicians as well researchers. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent® (KaVo) and scanning electron microscope (SEM). Materials and Methods: Ninety maxillary premolars were selected and divided into three groups of 30 teeth each: A (artificial saliva), B (CPP-ACP), and C (CPP-ACPF). All the samples were assessed using DIAGNOdent® at the baseline and after demineralization and remineralization. Three samples were randomly selected from each group after remineralization for surface evaluation using SEM. Results: Statistical analysis showed that group B {CPP-ACP (4.1±1.8)} and group C {CPP-ACPF (4.8±1.2)} had a significantly higher amount of remineralization than group A (1.7±0.7). Conclusion: All the three groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus®) showed marginally more amount of remineralization than CPP-ACP (Tooth Mousse®).

A comparative evaluation of DIAGNOdent with visual and radiography for detection of occlusal caries: An in vitro study.

Background: The diagnosis of dental caries is fundamental to the practice of dentistry. Despite the fact that dental caries has declined considerably, it is still a problem of great importance. The reduction in caries prevalence has not occurred uniformly for all the surfaces. The greatest reduction was observed at lesions located on smooth surfaces, so that occlusal caries are most common in children. Aim: The purpose of this study is to determine the clinical efficacy of DIAGNOdent in detecting occlusal caries. Materials and Methods: A total number of 50 teeth were subjected for visual, radiographic, and DIAGNOdent examinations. All the three methods were compared to histology which is a gold standard. Results: The result obtained showed that DIAGNOdent is superior to visual and radiographic methods in diagnosing occlusal caries.

An evaluation of the monitor effect of a laser-fluorescent divice during executing the ozone-remineralization treatment to dental caries of deciduous tooth / 实用口腔医学杂志

Traditional atraumatic restorative treatment(ART) induces more successive diseases in the treatment of deciduous caries. Ignoring the disinfection and caries-affected dentin's remineralisation are the main reasons of such problem. Nowadays, Ozone-Remineralisation therapy has become one of the steps before restorative treatment. However, there is no quantitative standard to evaluate this therapy. Some researches had shown that the laser-fluorescent device (DIAGNOdent, Dd) has the advantages in monitoring caries treatment. We use DIAG-NOdent to monitor the effect of OZone-Remineralisation therapy before filling the restoration in the caves in this study, however, the results is delievered that DIAGNOdent has little advatages in monitoring the effect of this new therapy, because the data of DIAGNOdent had a large fluctuation.

Assessment of diagnosis value of DIAGNOdent in early occlusal caries / 实用口腔医学杂志

Objective:To evaluate the diagnostic value of KaVo DIAGNOdent(DD)by comparing the diagnostic results of visual examination(VE)and stereomicroscope.Methods:The occlusal surface of 68 extracted teeth were examined by DD and VE,confirmed the examining points and marked,then cut these teeth along the markers.The results of stereomicroscope were classified into D0,D1,2,D3,4 according to the occlusal caries' depth,and recognized as gold standard.The difference of sensitivity,specificity between VE and DD,and their coherence were analyzed.Results:Sensitivity of DD,in D3,4 level of occlusal caries,was the highest.Compared to the results of stereomicroscope,the accuracy of DD and VE was the highest in D3,4 level.The coherence of DD and VE was low in all levels.Conclusion:The present cut-off point of DD affects the assessment of DD diagnostic result.Future study about key points of diagnosis of DD can widen its use in clinic.