Validity of Diagnosis of Questionable Caries Lesions in Occlusal Surfaces of Extracted Third Molars

1992 ◽  
Vol 26 (3) ◽  
pp. 188-194 ◽  
Author(s):  
A. Wenzel ◽  
O. Fejerskov
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabela Floriano ◽  
Elizabeth Souza Rocha ◽  
Ronilza Matos ◽  
Juliana Mattos-Silveira ◽  
Kim Rud Ekstrand ◽  
...  

Abstract Background Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status. Methods The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions. Results 205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91). Conclusions Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions.


Author(s):  
Fausto Medeiros Mendes ◽  
Victor Moreira Leamari ◽  
Márcia Turolla Wanderley ◽  
Mariana Minatel Braga ◽  
Juliana Mattos-Silveira ◽  
...  

Objective: This study aimed to investigate the association of two fluorescent dyes and Laser Fluorescence (LF) device in detecting smooth and occlusal natural caries in primary teeth in vitro.Methods: Measurements were performed with the LF and with LF associated with tetrakis (N-methylpyridyl)porphyrin (LF TMPyP) and protoporphyrin IX (LF PPIX) in 72 smooth (63 primary molars) and 134 occlusal sites (81 primary molars). For validation, surfaces were sectioned and sections obtained were evaluated under stereomicroscope. Smooth surfaces were also evaluated using polarized light microscopy and Knoop microhardness. For both smooth and occlusal surfaces, ROC analyses were performed, and sensitivities, specificities and accuracies were assessed. In smooth surfaces, Pearson’s correlation coefficients between LF values and lesions hardness or lesions depth were calculated.Results: LF TMPyP presented higher correlation with hardness and lesion depth than other methods in smooth surfaces. No differences were observed in other parameters among the methods, in both smooth and occlusal surfaces.Relevance: The LF TMPyP might improve performance in quantifying smooth-surface caries lesions in primary teeth. However, the sensitivity is improved at D2 (caries extending into inner half of the enamel but not to amelodentinal junction) threshold when using PPIX in smooth caries lesions. The association of LF with fluorescent dyes does not improve the performance on occlusal caries.


2014 ◽  
Vol 93 (11) ◽  
pp. 1070-1075 ◽  
Author(s):  
M. Fontana ◽  
J.A. Platt ◽  
G.J. Eckert ◽  
C. González-Cabezas ◽  
K. Yoder ◽  
...  

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.


Oral Diseases ◽  
2014 ◽  
Vol 21 (3) ◽  
pp. 299-307 ◽  
Author(s):  
I Floriano ◽  
GC Bonini ◽  
R Matos ◽  
TF Novaes ◽  
KR Ekstrand ◽  
...  

2020 ◽  
Vol 9 (6) ◽  
pp. 466-473
Author(s):  
Jorge A. Beltrán ◽  
◽  
Roberto A. León-Manco ◽  
Maria Eugenia Guerrero ◽  
◽  
...  

Objective: The objective of the study was to compare the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the detection of in vitro caries lesions. Material and Methods: One hundred teeth (46 molars and 54 premolars) were evaluated, including 176 proximal surfaces and 90 occlusal surfaces, with or without dental caries lesions. Digital images of all teeth were obtained using specific intraoral radiographs, VistaScan DürrDental®phosphor-plate radiography, XIOS XG Sirona® digital sensor radiography, and CBCT I-CATTM. Observers evaluated the images for the detection of caries lesions. The teeth were clinically sectioned and stereomicroscopy served as a validation tool. The relationship of sensitivity and specificity between all systems was determined through the ROC curve using Az values. Results: The values of the area under the curve (Az) selected for the CBCT I-CATTM system were 0.89 (0.84-0.93), for conventional radiography 0.71 (0.66-0.76), digital sensor radiography 0.74 (0.70-0.78) and digital radiography with phosphor-plates 0.73 (0.69-0.77). Statistically significant differences were found between the CBCT I-CATTM system and intraoral radiographic systems (p<0.01). The sensitivity and specificity values for the CBCT I-CATTM were 0.84 and 0.93 respectively. Conclusion: CBCT has a high sensitivity and specificity compared to intraoral radiographic systems for the diagnosis of dental caries lesions in vitro.


2016 ◽  
Vol 4 (1) ◽  
pp. 11-16
Author(s):  
Winnie Zhang

Third molars are highly variable in their presence and form. This report focuses on a horizontally impacted third molar and analyzes the potential etiology of this situation. Upon a clinical and radiographic examination, it was noted that the patient had four third molars present. The patient’s third molars began erupting around the age of 19. Currently, they are asymptomatic with incipient caries on the occlusal surfaces. While three of the third molars erupted in a normal orientation, one of the third molars (mandibular left) erupted in an orientation that would be classified as horizontal and/or mesio-angular. No treatment has been undertaken at the moment, however surgical extraction can be recommended with the prognosis being very good. For the clinician that has to treat dental complications that arise from abnormal tooth eruption, as seen in numerous genetic and acquired disorders, knowledge about the basic molecular mechanisms involved may become extremely important.


2020 ◽  
Vol 10 (6) ◽  
pp. 6688-6694

The present study aimed to compare the micro-tensile bond strength of new and conventional glass-ionomers and Z350 flowable composite resin to sound and caries-affected dentin. Eighty extracted third molars were selected. Standard Cl I cavities were prepared on occlusal surfaces. Forty teeth were assigned to the sound tooth group, and in the remaining 40 teeth, carious lesions were produced using a laboratory technique. Then each group (n=40) was subdivided into 5 groups (n=8) in terms of the restorative material used (EQUIA® Forte, Ketac Molar, encapsulated and hand-mixed GC Fuji II LC glass-ionomers and Z350 flowable composite resin). The cavities were restored. The highest micro-tensile bond strength was recorded with Z350 flowable composite resin in sound dentin (29.65), and the lowest was recorded with GC Fuji II LC (powder, liquid) in affected dentin (7.88). Significant differences were detected in the micro-tensile bond strength between the 5 restorative material groups. The composite resin bond strength was the maximum and was significantly different from all the other groups. The micro-tensile bond strength was affected by the type of dentin; in this context, in all the restorative groups, the bond strength in sound dentin was significantly higher than that in affected dentin. The most frequent failure mode was adhesive in the sound and affected dentin.


2006 ◽  
Author(s):  
Patara Ngaotheppitak ◽  
Cynthia L. Darling ◽  
Daniel Fried ◽  
Jeff Bush ◽  
Steve Bell

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Erol Cansiz ◽  
Sabri Cemil Isler ◽  
B. Alper Gultekin

Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.


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