Detection of Caries Around Amalgam Restorations on Approximal Surfaces

2016 ◽  
Vol 41 (1) ◽  
pp. 34-43 ◽  
Author(s):  
MB Diniz ◽  
RCL Cordeiro ◽  
AG Ferreira-Zandona
Keyword(s):  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Assessment System ◽  
Laser Fluorescence ◽  
Caries Detection ◽  
Posterior Teeth ◽  
Lower Accuracy ◽  
Amalgam Restorations ◽  
Approximal Surfaces

SUMMARYTo evaluate the in vitro performance of the International Caries Detection and Assessment System (ICDAS) visual examination, bitewing radiography (BW), and the DIAGNOdent 2190, a pen-type laser fluorescence device (LFpen), in detecting caries around amalgam restorations on approximal surfaces. Approximal surfaces (N=136) of permanent posterior teeth (N=110) with Class II amalgam restorations were assessed twice by two experienced examiners using ICDAS, BW, and LFpen. The occurrence of proximal overhangs was also evaluated. The teeth were histologically prepared and assessed for caries extension. Different cutoff limits for the LFpen were used. Intraexaminer and interexaminer reproducibility showed moderate to good agreement for all the methods (weighted κ/intraclass correlation coefficient=0.40 to 0.87). The specificities at D1 (all visible lesions affecting enamel) and D3 (lesions extended into dentin) were, respectively, 0.41 and 0.82 for ICDAS, 0.70 and 0.82 for BW, and 0.77-0.89 and 0.88-0.94 for LFpen. The sensitivities were 0.80 and 0.52 for ICDAS, 0.56 and 0.51 for BW, and 0.04-0.23 and 0.01-0.02 for LFpen at D1 and D3, respectively. At the D1/D3 thresholds, the accuracy and the area under the receiver operating characteristic curve (Az) values were similar and statistically higher for ICDAS (0.65/0.68 and 0.633/0.688) and BW (0.64/0.68 and 0.655/0.719), respectively; whereas, LFpen presented lower accuracy (0.37-0.44/0.49-0.52) and Az (0.390-0.454/0.345-0.395) values. The occurrence of overhangs (26.8%) was shown to be irrelevant in determining the presence of secondary caries. The ICDAS and BW methods presented the best performance in detecting caries lesions affecting enamel and dentin on approximal surfaces of amalgam restorations.

scholarly journals In vitro Detection of Occlusal Caries on Permanent Teeth by a Visual, Light-Induced Fluorescence and Photothermal Radiometry and Modulated Luminescence Methods

2015 ◽  
Vol 49 (5) ◽  
pp. 523-530 ◽  
Author(s):  
Mahmoud Jallad ◽  
Domenick Zero ◽  
George Eckert ◽  
Andrea Ferreira Zandona
Keyword(s):  
Preventive Intervention ◽  
Early Stage ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Assessment System ◽  
Photothermal Radiometry ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Occlusal Caries

Background: The paradigm shift towards the nonsurgical management of dental caries relies on the early detection of the disease. Detection of caries at an early stage is of unequivocal importance for early preventive intervention. Objective: The aim of this in vitro study is to evaluate the performance of a visual examination using the International Caries Detection and Assessment System (ICDAS) criteria, two quantitative light-induced fluorescence (QLF) systems - Inspektor™ Pro and QLF-D Biluminator™ 2 (Inspektor Research Systems B.V., Amsterdam, The Netherlands) - and a photothermal radiometry and modulated luminescence, The Canary System® (Quantum Dental Technologies, Toronto, Ont., Canada) on the detection of primary occlusal caries on permanent teeth. Methods: A total of 60 teeth with occlusal surface sites ranging from sound to noncavitated lesions (ICDAS 0-4) were assessed with each detection method twice in a random order. Histological validation was used to compare methods for sensitivity, specificity, percent correct, and the area under the receiver operating characteristic curve (AUC), at standard and optimum sound thresholds. Interexaminer agreement and intraexaminer repeatability were measured using intraclass correlation coefficients. Results: Interexaminer agreement ranged between 0.48 (The Canary System®) and 0.96 (QLF-D Biluminator™ 2). Intraexaminer repeatability ranges were 0.33-0.63 (The Canary System®) and 0.96-0.99 (QLF-D Biluminator™ 2). The sensitivity range was 0.75-0.96 while that of specificity was 0.43-0.89. The AUC were 0.79 (The Canary System®), 0.87 (ICDAS), 0.90 (Inspektor™ Pro), and 0.94 (QLF-D Biluminator™ 2). Conclusion: ICDAS had the best combination of sensitivity and specificity followed by QLF-D Biluminator™ 2 at optimum threshold.

scholarly journals Diagnosis of Pit-and-fissure Caries Using Three-dimensional Scanned Images

2018 ◽  
Vol 43 (3) ◽  
pp. E152-E157 ◽  
Author(s):  
JK Mitchell ◽  
AR Furness ◽  
RJ Sword ◽  
SW Looney ◽  
WW Brackett ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
In Vitro Study ◽  
Assessment System ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Scanned Images

SUMMARYDiagnosis of the extent of pit-and-fissure caries has been subjective and thus difficult to teach and categorize for treatment planning. This in vitro study compares occlusal caries diagnosis of extracted posterior teeth (n=49) using three-dimensional (3D) scanned images vs visual examination, according to the International Caries Detection and Assessment System (ICDAS). The surfaces chosen for study represent all ICDAS classifications. Five experienced restorative faculty members examined scanned images for 60 seconds from a standardized series of views of each surface and scored them independently. One month later, the same teeth were examined visually by the same five raters with magnification and LED headlamps, with compressed air available. Intrarater and interrater agreement and validity were assessed using intraclass correlation coefficients (ICCs). The ICCs, ranging from 0.90 to 0.93, indicated excellent agreement between and within raters and between the raters and the gold standard ICDAS determination. This suggests that both photographs and 3D scans of pits and fissures are equally effective in diagnosing caries.

scholarly journals SOPROLIFE System: An Accurate Diagnostic Enhancer

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mona Zeitouny ◽  
Mireille Feghali ◽  
Assaad Nasr ◽  
Philippe Abou-Samra ◽  
Nadine Saleh ◽  
...  
Keyword(s):  
Assessment Tool ◽  
High Reliability ◽  
Intraclass Correlation ◽  
High Sensitivity ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Icdas Ii

Objectives.The aim of this study was to evaluate a light-emitting diode fluorescence tool, the SOPROLIFE light-induced fluorescence evaluator, and compare it to the international caries detection and assessment system-II (ICDAS-II) in the detection of occlusal caries. Methods. A total of 219 permanent posterior teeth in 21 subjects, with age ranging from 15 to 65 years, were examined. An intraclass correlation coefficient (ICC) was computed to assess the reliability between the two diagnostic methods.Results.The results showed a high reliability between the two methods (ICC = 0.92; IC = 0.901–0.940;P<0.001). The SOPROLIFE blue fluorescence mode had a high sensitivity (87%) and a high specificity (99%) when compared to ICDAS-II.Conclusion.Compared to the most used visual method in the diagnosis of occlusal caries lesions, the finding from this study suggests that SOPROLIFE can be used as a reproducible and reliable assessment tool. At a cut-off point, categorizing noncarious lesions and visual change in enamel, SOPROLIFE shows a high sensitivity and specificity. We can conclude that financially ICDAS is better than SOPROLIFE. However SOPROLIFE is easier for clinicians since it is a simple evaluation of images. Finally in terms of efficiency SOPROLIFE is not superior to ICDAS but tends to be equivalent with the same advantages.

scholarly journals Detection of Caries Around Resin-Modified Glass Ionomer and Compomer Restorations Using Four Different Modalities In Vitro

2018 ◽  
Vol 6 (3) ◽  
pp. 47 ◽  
Author(s):  
Tamara Abrams ◽  
Stephen Abrams ◽  
Koneswaran Sivagurunathan ◽  
Veronika Moravan ◽  
Warren Hellen ◽  
...  
Keyword(s):  
Assessment System ◽  
Laser Fluorescence ◽  
Caries Detection ◽  
Signal Interference ◽  
Glass Ionomer ◽  
Icdas Ii ◽  
Resin Modified Glass Ionomer ◽  
Tooth Surfaces ◽  
Natural Decay

The aim of this study was to evaluate the ability of visual examination (International Caries Detection and Assessment System—ICDAS II), light-emitting diodes (LED) fluorescence (SPECTRA), laser fluorescence (DIAGNODent, DD), photothermal radiometry and modulated luminescence (PTR-LUM, The Canary System, CS) to detect natural decay beneath resin-modified glass ionomer (RMGIC) and compomer restorations in vitro. Twenty-seven extracted human molars and premolars, consisting of 2 control teeth, 10 visually healthy/sound and 15 teeth with natural cavitated lesions, were selected. For the carious teeth, caries was removed leaving some carious tissue on one wall of the preparation. For the sound teeth, 3 mm deep cavity preparations were made. All cavities were restored with RMGIC or compomer restorative materials. Sixty-eight sites (4 sites on sound unrestored teeth, 21 sound sites and 43 carious sites with restorations) were selected. CS and DD triplicate measurements were done at 2, 1.5, 0.5, and 0 mm away from the margin of the restoration (MOR). SPECTRA images were taken, and two dentists provided ICDAS II scoring for the restored surfaces. The SPECTRA data and images were inconclusive due to signal interference from the restorations. Visual examinations of the restored tooth surfaces were able to identify 5 of the 15 teeth with caries. In these situations, the teeth were ranked as having ICDAS II 1 or 2 rankings, but they could not identify the location of the caries or depth of the lesion. CS and DD were able to differentiate between sound and carious tissue at the MOR, but larger variation in measurement, and poorer accuracy, was observed for DD. It was concluded that the CS has the potential to detect secondary caries around RMGIC and compomer restorations more accurately than the other modalities used in this study.

scholarly journals Self-assembling Peptide P11-4 and Fluoride for Regenerating Enamel

2017 ◽  
Vol 97 (2) ◽  
pp. 148-154 ◽  
Author(s):  
M. Alkilzy ◽  
A. Tarabaih ◽  
R.M. Santamaria ◽  
C.H. Splieth
Keyword(s):  
Odds Ratio ◽  
Test Group ◽  
Assessment System ◽  
Laser Fluorescence ◽  
Fluoride Varnish ◽  
Caries Detection ◽  
Control Group ◽  
Analog Scale ◽  
Self Assembling ◽  
Carious Lesions

Regenerative medicine-based approaches for caries treatment focus on biomimetic remineralization of initial carious lesions as a minimal invasive therapy. In vitro, self-assembling peptide P11-4 enhances remineralization of early carious lesions. To investigate the safety and clinical efficacy of P11-4 for treatment of initial caries, a randomized controlled single-blind study was conducted on children aged >5 y with visible active early caries on erupting permanent molars. Subjects were randomized to either the test group (P11-4 + fluoride varnish) or control group (fluoride varnish alone). Caries were assessed at baseline and at 3 and 6 mo posttreatment per laser fluorescence, a visual analog scale, the International Caries Detection and Assessment System, and Nyvad caries activity criteria. Intention-to-treat analyses were performed, and safety and clinical feasibility of the treatment approaches were assessed. Compared with the control group, the test group showed clinically and statistically significant improvement in all outcomes at 3 and 6 mo. The laser fluorescence readings (odds ratio = 3.5, P = 0.015) and visual analog scale scores (odds ratio = 7.9, P < .0001) were significantly lower for the test group, and they showed regression in the International Caries Detection and Assessment System caries index (odds ratio = 5.1, P = 0.018) and conversion from active to inactive lesions according to Nyvad criteria (odds ratio = 12.2, P < 0.0001). No adverse events occurred. The biomimetic mineralization facilitated by P11-4 in combination with fluoride application is a simple, safe, and effective noninvasive treatment for early carious lesions that is superior to the presently used gold standard of fluoride alone. By regenerating enamel tissue and preventing lesion progression, this novel approach could change clinical dental practice from a restorative to a therapeutic approach. This could avoid additional loss of healthy hard tissue during invasive restorative treatments, potentially enabling longer tooth life and thereby lowering long-term health costs ( ClinicalTrials.gov NCT02724592).

scholarly journals In Vitro Detection of Caries Around Amalgam Restorations Using Four Different Modalities

2017 ◽  
Vol 11 (1) ◽  
pp. 609-620 ◽  
Author(s):  
Tamara E. Abrams ◽  
Stephen H. Abrams ◽  
Koneswaran S. Sivagurunathan ◽  
Josh D. Silvertown ◽  
Warren M.P. Hellen ◽  
...  
Keyword(s):  
Fluorescence Spectra ◽  
Visual Inspection ◽  
Laser Fluorescence ◽  
Amalgam Restoration ◽  
Icdas Ii ◽  
Sensitivity Specificity ◽  
Natural Decay ◽  
Amalgam Restorations ◽  
Carious Teeth

Objective:The aim of this study was to evaluate the ability of PTR-LUM (The Canary System, CS), laser fluorescence (DIAGNOdent, DD), LED fluorescence (Spectra), and visual inspection (ICDAS II) to detect natural decay around bonded amalgam restorationsin vitro.Methods:Seventeen extracted human molars and premolars, consisting of visually healthy (n=5) and natural cavitated (n=12) teeth were selected. For the carious teeth, caries was removed leaving some decayed tissue on the floor and or wall of the preparation. For sound teeth, 3 mm. deep cavity preparations were made and teeth were restored with bonded-amalgam restorations. Thirty-six sites (13 sound sites; 23 carious sites) were selected. CS and DD scans were performed in triplicate at 2, 1.5, 0.5, and 0 mm away from the margin of the restoration (MOR). Spectra images were captured for the entire surface, and dentists blinded to the samples provided ICDAS II scoring.Results:Canary Numbers (Mean±SE) for healthy and carious sites at 2, 1.5, 0.5, and 0 mm from the MOR ranged from 12.9±0.9 to 15.4±0.9 and 56.1±4.0 to 56.3±2.0, respectively. DD peak values for healthy and carious sites ranged from 4.7±0.5 to 13.5±2.99, and 16.7±3.7 to 24.5±4.4, respectively. For CS and DD, sensitivity/specificity for sites at 2.0, 1.5, 0.5, 0 mm ranged from 0.95-1.0/0.85-1.0, and 0.45-0.74/0.54-1.0, respectively. For ICDAS II, sensitivity and specificity were 1.0 and 0.17, respectively. For Spectra, data and images were inconclusive due to signal intereference from the amalgam restoration.Conclusions:Using thisin-vitromodel, CS and DD were able to differentiate between sound and carious tissue at the MOR, but larger variation, less reliability, and poorer accuracy was observed for DD. Therefore, CS has the potential to detect secondary caries around amalgam restorations more accurately than the other investigated modalities.

scholarly journals Approximal Caries Detection by DIFOTI:In VitroComparison of Diagnostic Accuracy/Efficacy with Film and Digital Radiography

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Á. Ástvaldsdóttir ◽  
K. Åhlund ◽  
W. P. Holbrook ◽  
B. de Verdier ◽  
S. Tranæus
Keyword(s):  
Diagnostic Accuracy ◽  
Digital Radiography ◽  
Characteristic Curve ◽  
Weighted Kappa ◽  
Caries Detection ◽  
Reference Standard ◽  
Dentin Caries ◽  
Diagnostic Threshold ◽  
Approximal Caries

The aim of the present study was to compare the diagnostic accuracy/efficacy of digital imaging fiber-optic transillumination (DIFOTI) with film and digital radiography, in detection of approximal caries lesions. One hundred and twelve approximal surfaces were scored for caries, using DIFOTI images film and digital radiographs. All three sets of images were examined twice by 8 observers, with a minimal interval of one week between examinations. Validation of histological sections served as a reference standard. Reproducibility, based on intra- and interobserver agreement, was similar for all three methods. At diagnostic threshold D1 (enamel and dentin caries), DIFOTI showed significantly higher sensitivity, but differences in specificity between methods were nonsignificant. Diagnostic accuracy in the form of area under the receiver operating characteristic curve (AUC) was significantly higher for DIFOTI. At diagnostic threshold D3 (dentin caries), the differences in sensitivity and AUC among methods were nonsignificant, but DIFOTI showed significantly lower specificity. Compared with the radiographs, DIFOTI showed closer agreement, expressed as weighted kappa values, with the reference standard. The results show that underin vitroconditions, the diagnostic accuracy of DIFOTI in detecting early approximal enamel lesions is greater than that of film and digital radiography, while the potential for detecting lesions in dentin is similar for all three methods.

Development of a Fluorescence-Based Caries Scoring System for an Intraoral Scanner: An in vitro Study

2020 ◽  
Vol 54 (4) ◽  
pp. 324-335
Author(s):  
Stavroula Michou ◽  
Ana Raquel Benetti ◽  
Christoph Vannahme ◽  
Pétur Gordon Hermannsson ◽  
Azam Bakhshandeh ◽  
...  
Keyword(s):  
Scoring System ◽  
State Of The Art ◽  
Assessment System ◽  
Detection Methods ◽  
Caries Detection ◽  
Fluorescence Signal ◽  
Radiographic Assessment ◽  
Intraoral Scanner ◽  
Posterior Teeth ◽  
Occlusal Surfaces

<b><i>Objectives:</i></b> To develop an automated fluorescence-based caries scoring system for an intraoral scanner and to<i></i>test the performance of the system compared to state-of-the-art methods. <b><i>Methods:</i></b> Seventy-three permanent posterior teeth were scanned with a three-dimensional (3D) intraoral scanner prototype which emitted light at 415 nm. An overlay representing the fluorescence signal from the tissue was mapped onto 3D models of the teeth. Multiple examination sites (<i>n</i> = 139) on the occlusal surfaces were chosen, and their red and green fluorescence signal components were extracted. These components were used to calculate 4 mathematical functions upon which a caries scoring system for the scanner prototype could be based. Visual-tactile (International Caries Detection and Assessment System, ICDAS), radiographic (ICDAS), and histological assessments were conducted on the same examination sites. <b><i>Results:</i></b> Most index tests showed significant correlation with histology. The strongest correlation was observed for the visual-tactile examination (<i>r</i><sub>s</sub> = 0.80) followed by the scanner supported by the caries classification function that quantifies the overall fluorescence compared to sound surfaces (<i>r</i><sub>s</sub> = 0.78). Additionally, this function resulted in the highest intra-examiner reliability (κ = 0.964), and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60–1.84) at the 2 histological levels where the comparison with visual-tactile assessment was possible (κ = 0.886, sum SE-SP = 1.57–1.81) and at the 3 out of 4 histological levels where the comparison with radiographic assessment was possible (κ = 0.911, sum SE-SP = 1.37–1.78); the only exception was for the lesions in the outer third of dentin, where the radiographic assessment showed the highest sum SE-SP (1.78). <b><i>Conclusion:</i></b> A fluorescence-based caries scoring system was developed for the intraoral scanner showing promising performance compared to state-of-the-art caries detection methods. The intraoral scanner accompanied by an automated caries scoring system may improve objective caries detection and increase the efficiency and effectiveness of oral examinations. Furthermore, this device has the potential to support reliable monitoring of early caries lesions.

Validation of DIAGNOdent laser fluorescence and the International Caries Detection and Assessment System (ICDAS) in diagnosis of occlusal caries in permanent teeth: an in vivo study

2016 ◽  
Vol 124 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Lia S. Castilho ◽  
Fernanda V. M. D. Cotta ◽  
Audrey C. Bueno ◽  
Allyson N. Moreira ◽  
Efigênia F. Ferreira ◽  
...  
Keyword(s):  
Assessment System ◽  
Laser Fluorescence ◽  
In Vivo Study ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Occlusal Caries

Diagnostic Performance of Different Methods in Detecting Incipient Non-Cavitated Occlusal Caries Lesions in Permanent Teeth

2019 ◽  
Vol 43 (3) ◽  
pp. 173-179
Author(s):  
Murat Ünal ◽  
Arzu Koçkanat ◽  
Seniha Güler ◽  
Esra Gültürk
Keyword(s):  
Intraclass Correlation ◽  
In Vitro Study ◽  
Roc Curves ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Kappa Statistics ◽  
Occlusal Caries ◽  
Diagnodent Pen ◽  
Icdas Ii

Aim: This in vitro study was aimed to investigate the performance of the new caries detection tools on the incipient occlusal caries. Study design: In our study, 100 permanent molar teeth, which were considered to have incipient, enamel caries (D1 and D2 threshold values) according to ICDAS II score. After the visual examination, caries measurements have been applied to all teeth by using DIAGNOdent pen (DP), CarieScan PRO (CP) and SoproLife camera (SC). In addition, in vitro examinations were repeated 2 weeks later. After sectioning and evaluation in stereomicroscope, the lesion depth was determined with histological criteria that are accepted for the gold standard for this research. Sensitivity, specificity, accuracy and area under the ROC curve were calculated at D1 and D2 thresholds. The intra-examiners' reproducibility were analysed using Cohen's kappa statistics and intraclass correlation coefficient (ICC). Results: Intra-examiner repeatability values varied from 0.94 to 0.99 and kappa values ranged from 0.90 to 0.99. While the highest sensitivity and specificity value showed for SC at D1 and D2 thresholds, CP presented the lowest values. The area under ROC curves (Az) varied from 0.70 to 0.99. ICDAS II showed the highest area under ROC curves (Az). Conclusions: ICDAS II, visual diagnostic method by itself is considered to sufficient in order to diagnose incipient occlusal caries. SC may be used as an alternative method for the ICDAS II, since its advantages by displaying caries lesion on the computer monitor, follow-up and motivation of the patients provided.

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