Correlation between Vista Cam, ICDAS-II, X-ray bitewings and cavity extent after lesion excavation: an in-vivo pilot study.

BACKGROUND: To correlate fluorescence-based camera (FC), visual inspection (ICDAS-II) and radiographic examination X-rays bitewings (BW) to the extent of caries after excavation. METHODS: The occlusal sites of 20 permanent first and second molars in 14 young adolescents (12±2 years old) were examined at 1st Observation Unit of Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome. All the enrolled patients were asked to provide with X-rays bitewing of the studied teeth. The assessment of ICDAS-II and FC was performed by a trained operator. Then a second blind operator removed the carious lesion and evaluated the cavity extent (depth, width, length) after caries removal with a calibrated probe. To correlate FC measurements with bitewing sensitivity, 10 dentists evaluated the presence/absence of caries on the X-rays. RESULTS: All the occlusal sites assessed by fluorescence camera, ranged from 1.7 to 2, indicating in all cases deep enamel lesions with possible extent to dentine with a mean of 1.7±0. In accordance, visual inspection by ICDAS-II showed scores of 3 and 4. By contrast, the radiographic documentation, i.e. bitewing X-rays, was evaluated in only 6 cases as presence of caries. The extent of the cavities was determined by three consecutive measurements: depth, width and length, with a mean of 3.5+1.73, 2.8+1.07 and 3.2+1.64 mm respectively. These results confirmed the agreement between FC and ICDAS-II for diagnosis of cavities with extent to enamel and dentine, while showed the low sensitivity of bitewings X-rays, in accordance with the existing evidence in Literature. Moreover, the results of this study for the first time provide information about the cavity extent after caries removal for the occlusal sites with ICDAS-II 3 and 4 scores and FC≥1.7. CONCLUSIONS: X-rays evaluation showed diagnostic accuracy in 6% of the sample. VistaCam measurement of 1.7 was correlated to a cavity with 3.5, 2.8 and 3.2 mm of depth, width and length.

A retrospective cohort study on peri-implant complications in implants up to 10 years of functional loading in periodontally compromised patients.

BACKGROUND: Prevalence of peri-implantitis is directly proportional to the time of functional loading. The aim of this retrospective study was to assess the survival and success rates as well as the incidence of peri-implantitis among patients with a history of periodontitis and among implants with 1 to 10 years of functional loading. METHODS: We evaluated clinical records of periodontally compromised patients treated between January 1998 and July 2002, with implants enrolled in a supportive periodontal and peri-implant treatment follow-up program. The following assessment indexes during follow-up were recorded: suppuration on probing, modified bleeding on probing, probing depth, implant mobility, bone changes, and criteria of success of Albrektsson. RESULTS: Clinical data of 475 patients with 1,991 implants were analyzed for a period of 10 years of functional loading. The survival and success rates were 91.8% and 75.4%, respectively, and the cumulative incidence of peri-implantitis among patients was 24.4%. The survival rate was 96.1%, and the success rate was 83.7% among implants. The incidence of peri-implantitis exhibited a peak rate after the seventh year (2.1%). The prevalence of peri-implantitis increased from 3.2% to 9.7% between 5 and 10 years of follow-up, and the peri-implantitis rate among implants was 12.9% after 10 years of functional loading. CONCLUSION: Peri-implantitis begins to appear more frequently after the fifth year of functional loading, especially between the seventh and eighth years of function.

Therapeutic efficacy of chlorhexidine-based mouthwashes and its adverse events: Performance-related evaluation of mouthwashes added with Anti-Discoloration System and cetylpyridinium chloride.

OBJECTIVES: To compare 3 mouthwashes: 0.20% chlorhexidine (CHX) with Anti-Discoloration System (ADS), 0.20% CHX and 0.12% CHX with 0.05% cetylpyridinium chloride (CPC), in terms of reduction of plaque and gingival bleeding and side effects. METHODS: Mild gingivitis patients were randomly divided into three Groups: they underwent professional oral hygiene and received instructions: oral rinse with 10 mL for 1', twice a day, 30' after tooth brushing, for 14 days. Primary outcomes were plaque and gingival bleeding, assessed with Plaque Control Record and Gingival Bleeding Index. Feedback questionnaire and spectrophotometer evaluated secondary outcomes: adverse events. Timing of the study was T0 (baseline), T1 (professional oral hygiene) and T2 (14th day after mouthwash use). RESULTS: Sixty-six patients were recruited, two patients dropped out, and 64 patients completed the study. PCR T1-T2 mean variation was 30.67 (SD = 15.22; 95% CI 23.55 to 37.80; P = 0.000), 19.93 (SD = 11.03; 95% CI 14.90 to 24.95; P = 0.000) and 16.24 (SD = 15.35; 95% CI 9.60 to 22.88; P = 0.000) respectively in Groups 0.2% CHX + ADS, 0.2% CHX and 0.12% CHX + CPC. GBI mean variation (T0-T2) was -9.82 (SD = 9.27; 95% CI -5.48 to 14.16; P = 0.000), -19.31 (SD = 11.33; 95% CI -14.15 to -24.47; P = 0.000) and -21.13 (SD = 12.56; 95% CI -15.70 to -26.56; P = 0.000) respectively in Groups 0.2% CHX + ADS, 0.2% CHX and 0.12% CHX + CPC. Statistical significance was found in lower efficacy of 0.2% CHX + ADS Group. Patients tolerated 0.12% CHX + CPC mouthwash better in bleeding perception (95.5%; P = 0.046), burning sensation (13.6%; P = 0.006), and mouthwash taste (100%; P = 0.000). Results on staining were no statistically significant (P = 0.106). CONCLUSIONS: Addition of CPC allows reduction of CHX percentage in mouthwash formulation while keeping equal efficacy and less side effects. ADS addition decreases CHX efficacy in reducing plaque and bleeding, while resulting more tolerated than CHX.

Evaluation of the esthetic properties of developmental defects of enamel: a spectrophotometric clinical study.

OBJECTIVES: Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectrophotometric evaluation. Developmental defects of enamel (DDE) are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. METHODS: Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L* (luminosity), a* (quantity of green-red), and b* (quantity of blue-yellow) of different DDE. CONCLUSIONS: SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization.