Remineralisation capability of silver diamine fluoride in artificial enamel lesions on smooth surfaces using quantitative light-induced fluorescence measurements in-vitro.

Enamel demineralisation can develop on smooth surfaces as an undesirable side effect during orthodontic treatment with fixed appliances. This study aimed to evaluate the ability of 38% silver diamine fluoride in remineralisation (as estimated by fluorescence gain) of artificial initial lesions in smooth surfaces of human enamel. The smooth surfaces of 50 human tooth samples were artificially demineralised and 45 samples were allocated randomly into three groups receiving a single treatment with a varnish: group I: Riva Star (silver diamine fluoride, SDF), group II: Bifluorid 12 (NaF, CaF2), and group III: Cervitec F (CHX, CPC, NH4F). Five samples were assigned as a negative control group without treatment. All samples were exposed to pH-cycling for 28 days. Fluorescence behavior was measured using Quantitative light-induced fluorescence before and after demineralisation and up to four weeks on a weekly basis. Analysis of variance (ANOVA) with Tukey-Kramer post-hoc tests and repeated measures ANOVA were used for statistical evaluation (α = 0.05). After demineralisation, all samples showed mean ΔF of - 16.22% ± 4.35, without significance differences between the fluorescence behaviour of the samples (p = 0.251). After 28 days group comparison showed a statistically significant difference (p = 0.034) for ΔF values: the lowest fluorescence values were found in group I (SDF, mean ΔF - 16.47 ± 6.08) with a significant difference compared to group III (Cervitec F, mean ΔF - 11.71 ± 4.83). In group II (Bifluorid 12) mean ΔF value was - 15.55 ± 2.15) without statistically significant differences to groups I and III. The fluorescence behaviour of SDF varnish on smooth surfaces with artificial initial enamel lesions was significantly lower compared to Cervitec F varnish after short time use.

Anomalous KCl(001) Surface Corrugation from Fast He Diffraction at Very Grazing Incidence.

We present theoretical and experimental evidence of an anomalous surface corrugation behavior in He-KCl(001) for incidence along ⟨110⟩. When the He normal energy decreases below 100 meV, i.e., He-surface distances Z>2 Å, the corrugation unexpectedly increases up to an impressive ≳85%. This is not due to van der Waals interactions but to the combination of soft potential effects and the evolution of He-cation and He-anion interactions with Z. This feature, not previously analyzed on alkali-halide surfaces, may favor the alignment properties of weakly interacting overlayers.

How to intervene in the caries process: proximal caries in adolescents and adults-a systematic review and meta-analysis.

OBJECTIVES: For an ORCA/EFCD consensus, this systematic review assessed the question "How to intervene in the caries process in proximal caries in adolescents and adults". MATERIAL AND METHODS: Separating between the management of initial and cavitated proximal caries lesions, Medline via PubMed was searched regarding non-operative/non-invasive, minimally/micro-invasive and restorative treatment. First priority was systematic reviews or randomized controlled trials (RCTs), otherwise cohort studies. After extraction of data, the potential risk of bias was estimated depending on the study type, and the emerging evidence for conclusions was graded. RESULTS: Regarding non-invasive/non-operative care (NOC), no systematic reviews or RCTs were found. In cohort studies (n = 12) with a low level of evidence, NOC like biofilm management and fluoride was associated with a low proportion and slow speed of progression of initial proximal lesions. Minimally/micro-invasive (MI) treatments such as proximal sealants or resin infiltration (four systematic reviews/meta-analyses) were effective compared with a non-invasive/placebo control at a moderate level of evidence. Data on restorative treatment came with low evidence (5 systematic reviews, 13 RCTs); with the limitation of no direct comparative studies, sample size-weighted mean annual failure rates of class II restorations varied between 1.2 (bulk-fill composite) and 3.8% (ceramic). Based on one RCT, class II composite restorations may show a higher risk of failure compared with amalgam. CONCLUSIONS: Proximal caries lesions can be managed successfully with non-operative, micro-invasive and restorative treatment according to lesion stage and caries activity. CLINICAL RELEVANCE: Proximal caries treatment options like non-operative, micro-invasive and restorative care should be considered individually.

[The "safe" flap - Preoperative perforator-mapping and intraoperative perfusion assessment to reduce flap-associated morbidity - Consensus statement of the German Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels]. / Der sichere Lappen ­ Präoperatives Gefäß-Mapping und intraoperative Perfusionsmessung zur Reduktion der lappenbedingten Morbidität.

Reconstructive microsurgery using free and pedicled flaps has become a reliable method with a high success rate. Preoperative perforator mapping and intraoperative assessment of perfusion might further reduce flap-associated morbidity.There are various techniques for perforator mapping and perfusion measurement, but no guidelines regarding their use. Therefore, an expert panel at the 40th Annual Meeting of the German-Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels (DAM) discussed and critically reviewed the current literature. The consensus statement represents the expert opinion based on the available literature and provides recommendations regarding the use of preoperative perforator mapping and intraoperative perfusion measurement.

Randomised in situ clinical trial investigating self-assembling peptide matrix P11-4 in the prevention of artificial caries lesions.

The aim was to investigate the ability of self-assembling Peptide P11-4 Matrix (SAPM) to remineralize artificial initial caries lesions compared to the use of fluoride varnish. Volunteers were recruited for this randomised, cross-over in situ trial. Bovine specimens, half including orthodontic brackets, were recessed on the buccal aspects of mandibular appliances. Specimens included internal sound enamel control, a demineralised control and a part exposed during the in situ phase. Each phase lasted four weeks, followed by a one-week washout. Treatment groups were: A: negative control, no treatment,B: positive control, 22,600 ppm fluoride varnish,C: test group, 1,000 ppm SAPM. Laser fluorescence values (LF) were measured before/after demineralisation, and after the in situ period. Micro-CT analysis was used to assess mineral changes within the specimens after the in situ phase. In specimens without brackets, ΔLF values after in situ phase were: A: +5.28, B: +0.85, C: -2.89. Corresponding ΔLF for specimens with brackets were: A: +5.77, B: +1.30, C: -3.15. LF-values between groups significantly differed from each other (p < 0.0001) after the in situ phase. Micro-CT analysis yielded no significant difference among groups for specimens without brackets. For specimens with brackets, the test group showed significantly more remineralisation than the negative (p = 0.01) and positive control (p = 0.003). Within the limitations of the study, SAPM showed prevention of caries and remineralisation of enamel around orthodontic brackets.

Circulating levels of fibroblast growth factor 21 in early-stage diabetic kidney disease.

AIMS/PURPOSE: Fibroblast growth factor 21 (FGF21), a hepatoadipokine with pleiotropic metabolic regulatory actions, is emerging as a novel biomarker of progressive nephropathy. We sought to evaluate circulating FGF21 and its association with clinical and biochemical characteristics as well as the urinary albumin excretion (UAE) rates in a population of patients with type 2 diabetes (T2D) with or without microalbuminuria and their matched healthy controls. METHODS: Cross-sectionally, 130 consecutive individuals comprising patients with T2D with (n = 44) or without (n = 44) microalbuminuria and their healthy controls (n = 42) were recruited for analysis. Various demographic, clinical and biochemical parameters were assessed. RESULTS: Serum FGF21 levels were significantly elevated in patients with microalbuminuria [median (interquartile range, IQR): 269.50 (188.50) pg/mL] compared to their normoalbuminuric peers with T2D [median (IQR): 103.50 (75.75) pg/mL] and nondiabetic people [median (IQR): 99.00 (126.75) pg/mL]. While serum FGF21, diastolic blood pressure and duration of diabetes mellitus (DDM) were independently associated with microalbuminuria in the baseline logistic regression model, FGF21 and DDM emerged as significant correlates in the multivariate adjusted model (OR for FGF21 = 1.060, 95% CI = 1.011-1.110, P < .016). CONCLUSIONS: Serum FGF21 level is strongly associated with early-stage diabetic kidney disease in the high-risk population of patients with T2D (particularly with circulating FGF21 values rising above 181 pg/mL). The association of serum FGF21 with subclinical stages of diabetic nephropathy may unearth perspectives on early detection and prevention of the advanced stages of chronic diabetes microvascular complications through effective FGF21-targeted therapy.

Radiographic diagnosis of proximal caries-influence of experience and gender of the dental staff.

OBJECTIVES: The aim of this study was to examine the influence of experience and gender on the radiographic detection of proximal caries lesions and on therapeutic decisions. MATERIALS AND METHODS: A survey of 220 examiners (students and employees at three universities and dentists in the field) was taken using a standardized written questionnaire concerning radiographic diagnosis and therapy planning. An expert opinion of four dentists was determined as radiographic reference. A mixed effect logistic regression model was used for statistical evaluation and the odds ratio and p values were calculated (α = 0.05). RESULTS: Examiners with experience had an almost four times greater chance of a correct assessment, if proximal caries lesion was present or not, than examiners with low experience (OR 3.7 (95% CI 2.4-5.8)). No gender-specific differences were discovered (OR women vs. men 0.9 (95% CI 0.6-1.4)). There was a relationship between the severity of the burnout effect on the x-ray and false positive caries diagnosis. Overall, 43% of respondents would plan invasive treatment in the enamel on a patient at low risk of caries and 78% on a high-risk patient. The results showed that the more experienced practitioners would be more likely to postpone restorative therapy on proximal caries until the lesion reached a later stage. CONCLUSIONS: The results of this study suggest that examiner's experience influences the radiographic diagnosis of proximal lesions. No gender-specific differences could be found. CLINICAL RELEVANCE: Examiner's professional experience is an important factor when radiography is included for detection and treatment planning of proximal lesions.

Comparison of occlusal caries detection using the ICDAS criteria on extracted teeth or their photographs.

BACKGROUND: Using photographs of occlusal surfaces instead of extracted teeth for the detection of caries can be useful in multicenter studies or education. Using a panel of observers, ICDAS scores on teeth or photographs were evaluated against the histological gold standard. The hypothesis was that both outcomes were equivalent. METHODS: Four examiners with different experience in ICDAS scored photographs of occlusal surfaces of 100 extracted teeth on a monitor using ICDAS criteria. Two of the examiners had previously scored extracted teeth prior to photography. Digital images of histological sections of the teeth were observed by all examiners and consensus scores were given for each investigation site (gold standard). Kappa statistics and Spearman correlation coefficients as well as repeated measure ANOVA were performed. ROC curves were constructed for each examiner and the areas under the ROC-curves (AUC) of both scoring techniques (extracted teeth, digital images) were compared (α = 0.05). RESULTS: Intra- and inter-rater kappa for ICDAS on teeth were 0.81-0.94 and on photographs 0.54-0.88, respectively. Correlation with histology was 0.58- 0.61 for the teeth and 0.50-0.62 for the photographs. AUC of ICDAS scores of extracted teeth (mean 0.89) were slightly higher than those for photographs (mean 0.84). However, both AUC values were not statistically significant (p = 0.38). CONCLUSION: Using photographs to assess occlusal surfaces with the ICDAS criteria was not statistically different from scoring the extracted teeth.

The Role of Current Techniques and Concepts in Peripheral Nerve Repair.

Patients with peripheral nerve injuries, especially severe injury, often face poor nerve regeneration and incomplete functional recovery, even after surgical nerve repair. This review summarizes treatment options of peripheral nerve injuries with current techniques and concepts and reviews developments in research and clinical application of these therapies.

[Evaluation of an Intensified Dental Preventive Programme Aimed at Children with Increased Caries Risk]. / Evaluation eines zahnmedizinischen Präventionsprogramms für Kinder mit erhöhtem Kariesrisiko.

Our study investigated the effect of a selective intensive prevention (SIP) programme on dental health of pupils in comparison to a control group. While no differences were observed in respect to dental health of first graders, the DMF-T values of fourth and 6 graders participating in SIP were significantly lower. Concerning the psychometric variables only few differences were found. The fourth and 6 graders in the test group reported less dental fear than the pupils in the control group.

Efficacy of the self-assembling peptide P11-4 in constructing a remineralization scaffold on artificially-induced enamel lesions on smooth surfaces.

OBJECTIVES: The management of white-spot lesions remains a challenge, especially during and after fixed orthodontic treatment. The aim of this in vitro study was to evaluate the efficacy of the newly introduced self-assembling peptide P11-4 (Curodont™) for regenerating demineralized tooth tissue on smooth surfaces. Another aim was to evaluate whether the DIAGNOdent (DD) and VistaProof (VP) fluorescence systems are suitable for differentiating between demineralized and remineralized enamel. MATERIALS AND METHODS: A total of 40 sound samples (buccal surfaces) of extracted human posterior teeth were artificially demineralized. The samples were examined visually as well as via DD and VP. Curodont was applied to 30 samples which were then stored in a remineralizing agent (test group). In control group 1, Curodont was applied to 5 samples which were then stored in water. Control group 2 consisted of 5 samples stored in the remineralizing agent only. Sample surfaces were examined visually and by means of DD and VP after 1 week (t1), 8 weeks (t2), and 12 weeks (t3). All fluorescence measurements were taken twice. Sample surfaces were viewed using a scanning electron microscope (SEM). Statistical analysis was conducted using the IBM SPSS® Statistics and MedCalc® programs. The fluorescence measurements' reproducibility was calculated using the intraclass correlation coefficient (ICC). A χ(2) test was applied to detect any significant differences between the fluorescence measurements of the test and control groups at each examination. Receiver operating characteristic (ROC) curves of DD and VP were constructed and areas under the ROC curve (AUC) were compared (α = 0.05) between the two fluorescence devices. RESULTS: Reproducibility of DD was moderate at t3, while the ICC values were high for all other measurements. Significant differences between the fluorescence measurements at t2 and t3 between the test and control groups (p < 0.001 for DD and VP, respectively) were observed. The performance (AUC) of DD was significantly higher than VP (visual inspection: p = 0.017; SEM: p = 0.030). At t3, all test-group samples displayed a shinier surface than the surface after demineralization. The SEM images of 28 test-group samples exhibited extensive signs of remineralized enamel. CONCLUSION: Based on visual inspection, Curodont proved to be efficacious in all samples. The SEM images revealed large areas of remineralized enamel surface in 93 % of the samples. Both fluorescence systems enabled the detection of differences between the measurements of the test and control groups after 8 and 12 weeks.

Transient quantum trapping of fast atoms at surfaces.

We report on the experimental observation and theoretical study of the bound state resonances in fast atom diffraction at surfaces. In our studies, the 4He atom beam has been scattered from a high-quality LiF(001) surface at very small grazing incidence angles. In this regime, the reciprocal lattice vector exchange with the surface allows transient trapping of the 0.3-0.5 keV projectiles into the quasistationary states bound by the attractive atom-surface potential well which is only 10 meV deep. Analysis of the linewidths of the calculated and measured resonances reveals that prior to their release, the trapped projectiles preserve their coherence over travel distances along the surface as large as 0.2 µm, while being in average only at some angstroms in front of the last atomic plane.

[Dental health in 12-year-old children including initial lesions and dentine caries]. / Zahngesundheit bei 12-Jährigen unter Einbeziehung von Initialläsionen und Dentinkaries.

AIM: The aim of this study was to assess caries prevalence among 12-year-olds, including initial lesions and dentine caries (ICDAS-II criteria, Codes 0-6). METHODS: The study was conducted in 2 regions of Hesse with different group prevention programmes (in region 1 children receive regular school-based prophylaxis using fluoride varnish twice a year from 1(st)-6(th) grade, in region 2 there is no use of fluoride varnish in schools. The samples were selected by a random sampling procedure using a list of all public schools. Dental caries was recorded on surface base and the presence of sealants was recorded. Additionally, a school-based analysis was performed. Statistical analysis was performed using SPSS 17.0. To compare the mean caries scores of the subgroups, non-parametric tests were performed (α=0.05). RESULTS: 270 12-year-olds were examined in each region. Mean DF-S values were: Region 1: D1-6FS=1.61; D1+2FS=1.5; D3-6FS=0.84; D5+6FS=0.74. Region 2: D1-6FS=2.8; D1+2FS=2.3; D3-6FS=1.1; D5+6FS=0.72. In region 2 significantly more initial lesions were assessed (p=0.01, D1+2FS). The difference between the regions was not statistically significant at the level of dentine caries (p=0.531, D3-6FS and p=0.113, D5+6FS). In region 1 mean DFS values differ significantly between children with and without fissure sealants at all levels (p<0.05). The analysis for region 1 based on the type of school visited showed a significant difference of mean D1+2F-S and D1-6F-S values (p=0.01 and p=0.012, respectively). CONCLUSION: In total, the caries prevalence in both regions was low. Differences between mean DFS values were clearer when initial lesions were included. The results point out the impact of assessing initial lesions for evaluation of prevention programs.

Caries prevalence in 12-year-old children from Germany: results of the 2009 national survey.

OBJECTIVE: In 2009, complementary epidemiological studies were conducted in 16 German states. DESIGN: A 2009 cross-sectional oral health survey of children aged 12 years with 5% samples selected using a two-stage random sampling procedure. SUBJECTS: A random selection of 30,943 12-year-olds were examined in schools. METHOD: DMFT and fissure sealants were recorded following WHO criteria. Caries was diagnosed at the caries into dentine threshold (D3) using the visual method without radiography or fibre-optic transillumination. Statistical evaluation was performed using the software SPSS (v12.0). RESULTS: The proportion of children across Germany with caries experience was 31%. The mean DMFT score was 0.72 and the average Significant Caries Index (SiC) was 2.29. The results showed a wide variation among the different federal states, with mean regional DMFT values ranging from 0.56 to 1.06. Compared to the results obtained in 2004, caries prevalence and caries experience decreased distinctly in this age group. The mean DMFT score for 12-year-olds dropped from 2.44 to 0.72 between 1994 and 2009. The mean DMFT scores were 72.7% lower at the end of the observation period than a few years after the introduction of extensive caries prevention measures in Germany. The mean number of fissure sealed teeth ranged between 2.24 and 3.04. CONCLUSION: The decrease in caries prevalence observed between 1994 and 2004 continued between 2004 and 2009, although once again inequalities in oral health between federal states were observed.

High resolution imaging of superficial mosaicity in single crystals using grazing incidence fast atom diffraction.

A new table top technique is used to simultaneously analyze the local morphology of crystalline surfaces as well as the misalignment of large scale domains at the topmost surface layer. The approach is based on fast atom diffraction at grazing incidence (GIFAD); the diffraction pattern yields the structural characteristics and the topology of the surface electronic density with atomic resolution. If superficial mosaicity is present, diffraction patterns arising from each mosaic domain can be distinguished, providing high sensitivity to the properties of each of the domains. Taking NaCl(001) as an example, we observe a discrete tilt angle distribution of the mosaic domains following an arithmetic progression with a 0.025° ± 0.005° difference; a twist mosaic angle of 0.09° ± 0.01° is also observed.

Serum leptin level has a positive correlation with BMI and creatinine clearance in CAPD patients.

OBJECTIVE: In a cross sectional study, 75 patients (42 males and 33 females) on continuous ambulatory peritoneal dialysis (CAPD) were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, triglyceride, dialysis adequacy (total KT/V), renal creatinine clearance (Cr Cl), mid arm circumference and demographic findings were measured in all patients. RESULTS: The mean age of patients was 53±14.76. The history of hemodialysis was seen in 23 patients. Mean serum leptin level in women and men were 27±23µg/l and 16±13µg/l, respectively. A significant correlation of serum leptin level with body mass index (BMI) (p<0.001) and renal Cr Cl (p<0.001) was found. There was no significant correlation of serum leptin level with KT/V, duration of renal failure, serum triglycerides (TG), serum low density lipoprotein (LDL) cholesterol and mid arm circumference (p>0.05). CONCLUSIONS: To our knowledge, this is probably the first study to report that serum leptin level has a direct positive correlation with renal Cr Cl in CAPD patients. This may explain the increase in mortality in patients with lower serum leptin levels (Tab. 2, Fig. 2, Ref. 25).

[Soft tissue reconstruction with a temporoparietal fascial flap (TPFF)]. / Der temporoparietale Faszienlappen zur Rekonstruktion von Weichteildefekten.

OBJECTIVE: Soft tissue reconstruction with a temporoparietal fascial flap (TPFF). INDICATIONS: Defect coverage with thin, pliable, and well-vascularized tissue. A bilayered TPFF provides a gliding surface in tendon reconstruction. Further options include TPFF harvest with overlying skin or subjacent bone for composite tissue reconstruction or the application as a sensate local fascial flap. Maximum defect dimensions: 17 × 14 cm. CONTRAINDICATIONS: Absolute: prior injury to the flap or flap pedicle, temporal arteritis, Moyamoya syndrome, defects with volume deficit. Relative: alopecia along the planned incision. SURGICAL TECHNIQUE: Pedicle location is outlined using Doppler ultrasound. Injection of the incision line with diluted epinephrine solution. Skin incision with subsequent visualization of the temporoparietal fascia and supplying vessels. Skin flaps are raised carefully paying special attention to the hair follicles (CAVE: postoperative alopecia). Primary closure of the donor site. Defect coverage with pedicled or free TPFF with subsequent full or split-thickness skin grafting. Dressing: Bolster or V.A.C. POSTOPERATIVE MANAGEMENT: Immobilization/elevation in the setting of extremity reconstruction. Removal of bolster dressing or V.A.C. on postoperative day 5. Dangling protocol instituted on postoperative day 7. Removal of sutures/staples at the donor site on postoperative day 5-7 and at the recipient site on postoperative day 12-14. RESULTS: The TPFF was utilized for soft tissue reconstruction in 8 patients. A pedicled TPFF was used in 2 patients. Mean time to healing was 16.3 days. Mean follow-up was 13.4 months. Successful reconstructive results with satisfactory functional and aesthetic appearance were obtained in all patients. Complications were encountered in 3 patients and included alopecia at the donor site and iatrogenic injury to the frontal branch of the facial nerve. Vascular compromise was observed in the early postoperative period in a third patient. However, operative revision resulted in successful flap salvage.

[Evidence-based medicine--principles and impact on plastic surgery]. / Evidenz-basierte Medizin--Prinzipien und Bedeutung für die Plastische Chirurgie.

The increasing importance of evidence-based medicine (EBM) is the result of an increasing demand for a rational decision-making process in healthcare. It has been demonstrated that 15-40% of decisions made in healthcare do not have a solid scientific basis. This is particularly problematic in times of limited financial resources, when reimbursement increasingly depends on how "evidence-based" a particular treatment is. Application of EBM principles in plastic surgery is therefore no longer an option. This, however, requires a basic understanding of the existing levels of evidence. In the present article, principles of EBM will be presented. The importance of randomized controlled trials and systematic reviews for plastic surgery will be highlighted along with a discussion of the quality of the plastic surgical literature based on results of recent systematic analyses. The plastic surgical community has appreciated the need for higher quality clinical studies. Improvement of the quality of reporting is, however, critical.

Effectiveness of four electronic apex locators to determine distance from the apical foramen.

AIM: To evaluate the accuracy of four electronic apex locators (EAL) in the apical region (0-3 mm short of the foramen) and to compare the precision of the readings on the display with the real position of the file in the root canal. METHODOLOGY: Twenty single-rooted extracted teeth with round root canals were used. The canal orifices were preflared, and the length to the major foramen was determined visually under a microscope. Canals were enlarged, so that a size 15 file fitted well inside the canal. Teeth were mounted in acrylic test tubes filled with physiologic saline solution. Electronic length was determined in the region between the major foramen and 3 mm short of it in 0.5 mm steps with the Dentaport ZX, Root ZX mini, Elements Diagnostic Unit and Apex Locator and Raypex 5 using files of size 10 and size 15. The data were analysed using linear regression between true length and EAL reading, Bland-Altman plots and nonparametric tests at a significance level of alpha = 0.05. RESULTS: The major foramen was detected by all EALs. With a measurement file positioned directly at the major foramen, meter readings were equivalent to a position 0.01-0.38 mm away. For the Dentaport ZX, a better accuracy using the size 15 file for the area 0-1.5 mm short of the apex was found. The differences in measurements between the two files were smaller for the other EALs. In linear regression, a good linearity for Dentaport ZX and Root ZX mini and moderate linearity for Elements Diagnostic Unit and Apex Locator and Raypex 5 were found. The slope of the measurement curve was too low (0.37-0.57) for the Raypex 5 and almost optimal for the Dentaport ZX (1.01-1.05). The Root ZX mini and the Elements Obturation Unit produced lower slope values and especially the Elements Obturation Unit revealed much higher SDs at the different measurement levels. CONCLUSION: Amongst the four EALs, the Dentaport ZX and Root ZX mini had the best agreement between true lengths and meter readings. For the Raypex 5, an interpretation of the colour-coded zones as distance to the foramen cannot be recommended and might lead to erroneous interpretations.

Effect of different time intervals between examinations on the reproducibility of ICDAS-II for occlusal caries.

AIM: To evaluate intra- and interexaminer reproducibility of ICDAS-II on occlusal caries diagnosis when different time intervals were allowed to elapse between examinations. A subsidiary aim was to determine whether collapsing the codes would influence this reproducibility. METHODS: The occlusal surfaces of 50 permanent posterior teeth were investigated by 3 trained examiners using ICDAS-II at baseline, 1 day, 1 week and 4 weeks after baseline. RESULTS: Weighted kappa values for intra- and interexaminer reproducibility were 0.76-0.93. CONCLUSION: The time span did not have a major impact on assessing intra- and interexaminer reproducibility. Collapsing ICDAS-II codes had no impact on examiner reproducibility.