Monique Saveriano De Benedetto

Performance of fluorescence‐based and conventional methods of occlusal caries detection in primary molars – an in vitro study

AIM This in vitro study aimed to test the performance of fluorescence-based methods in detecting occlusal caries lesions in primary molars compared to conventional methods. DESIGN Two examiners assessed 113 sites on 77 occlusal surfaces of primary molars using three fluorescence devices: DIAGNOdent (LF), DIAGNOdent pen (LFpen), and fluorescence camera (VistaProof-FC). Visual inspection (ICDAS) and radiographic methods were also evaluated. One examiner repeated the evaluations after one month. As reference standard method, the lesion depth was determined after sectioning and evaluation in stereomicroscope. The area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentine caries (D3) lesions thresholds. The intra and interexaminer reproducibility were calculated using the intraclass correlation coefficient (ICC) and kappa statistics. RESULTS At D1, visual inspection presented higher sensitivities (0.97-0.99) but lower specificities (0.18-0.25). At D3, all the methods demonstrated similar performance (Az values around 0.90). Visual and radiographic methods showed a slightly higher specificity (values higher than 0.96) than the fluorescence based ones (values around 0.88). In general, all methods presented high reproducibility (ICC higher than 0.79). CONCLUSIONS Although fluorescence-based and conventional methods present similar performance in detecting occlusal caries lesions in primary teeth, visual inspection alone seems to be sufficient to be used in clinical practice.

New methodology to assess activity status of occlusal caries in primary teeth using laser fluorescence device

An in vivo study was conducted to verify the ability of laser fluorescence (LF) to assess the activity status of occlusal caries in primary teeth, using different air-drying times. Occlusal sites (707) were examined using LF (DIAGNOdent) after air-drying for 3 s and 15 s, and the difference between readings (DIF15 s-3 s) was calculated. For concurrent validation of LF, visual criteria-Nyvad (NY) and Lesion Activity Assessment associated with the International Caries Detection and Assessment System (LAA-ICDAS)-were the reference standards for lesion activity. Histological exam using a pH-indicator dye (0.1% methyl red) was performed in 46 exfoliated/extracted teeth for criterion validation. LF readings and DIF15 s-3 s were compared using Kruskall-Wallis and Mann-Whitney tests. Receiver operating characteristic analyses were performed and validity parameters calculated, considering the caries activity assessment. Using NY, active lesions (3 s: 30.0+/-29.3; 15 s: 34.2+/-30.6) presented higher LF readings than inactive lesions (3 s: 17.0+/-16.3; 15 s: 19.2+/-17.3; p<0.05), different from LAA-ICDAS. Active cavitated caries resulted in higher LF readings (3 s: 50.3+/-3.5; 15 s: 54.7+/-30.2) than inactive cavitated caries (3 s: 19.9+/-16.3; 15 s: 22.8+/-16.8). Therefore, LF can distinguish cavitated active and inactive lesions classified by NY, but not by LAA-ICDAS; however, this difference might be related to the visual system rather than to LF. The air-drying time could be an alternative to improve the caries activity assessment; however, longer air-drying time is suggested to be tested subsequently.

Performance of fluorescence‐based methods for detecting and quantifying smooth‐surface caries lesions in primary teeth: an in vitro study

BACKGROUND Although smooth-surface caries can be subjectively assessed by visual inspection, quantitative methods would improve the monitoring of these lesions. AIM To evaluate the in vitro performance of laser fluorescence devices, namely DIAGNOdent (LF) and DIAGNOdent pen (LFpen), and a fluorescence camera (VistaProof; FC) in the detection and quantification of smooth-surface caries in primary teeth. DESIGN Two examiners evaluated 99 smooth surfaces of 65 extracted primary molars using FC, LF, and LFpen. As a reference standard, the actual and relative lesion depths were determined using stereomicroscopy and polarized light microscopy. Reproducibilities were assessed, and correlation analyses were performed. The sensitivities, specificities, and accuracies of the methods were calculated and compared. RESULTS There was a significant correlation between the values obtained using the fluorescence-based devices and the actual and relative lesion depths, although the correlation coefficient values were not higher than 0.7 (LF, 0.673; LFpen, 0.646; FC, 0.663). The sensitivities of the devices were similar for the detection of enamel caries, although LFpen was superior in detecting dentin lesions. The reliabilities of all methods were moderate to low, with similar accuracies at all depths. CONCLUSION Although the fluorescence-based devices showed similar performance in the detection of enamel and dentin lesions, the reliability of these devices and the correlation of their findings with the actual and relative lesion depths were moderate with regard to smooth-surface caries in primary molars.

Child's anxiety preceding the dental appointment: evaluation through a playful tool as a conditioning feature

Objective: The aim of this study was to evaluate the emotional reactions before and after the application of a child audiovisual book that illustrates the trigger fear and anxiety points in the dental appointment. Moreover, the educational effect of this book as preconditioning to dental care was also verified. Methods: The study is a prospective pilot study conducted at the University of Western Santa Catarina with a convenience sample of 20 children aged 4-6 years old, with and without previous dental experience. All these children received the book and they were assessed before and after the presentation by responsible attendants. The projective test FIS (Facial Image Scale) was applied in 2 stages on the same day of assistance. Both tests were applied at the reception waiting room: before the child came into contact with the book in the dental clinic room and after the child came into contact with the playful instrument. Anamnesis and clinical examination were performed in the dental office by the dentist to start or continue the treatment. Results: The children were able to answer the projective test with self -analysis. The idealized audiovisual book was successfully constructed and used in the research. The comparison between FIS 1 and FIS 2 made with paired t-test showed significant improvements by comparing the results before the presentation of the playful instrument and after the use of it (p <0.0001), with no differences in childhood anxiety between genders and ages. Conclusion: The result of the conditioning technique using the book before the dental treatment was highly significant in reducing anxiety.

Two endodontics techniques analysis in primary molars with fistula

OBJECTIVE: The purpose of this research was to follow the radiolucent area (pixels) in the furcation area and the behavior of the endodontically treated deciduous molars with different simplified echniques.METHODS: The treatments were performed without the duct instrumentation using relative isolation and two drugs were applied, as follows: G1: Guedes-Pinto paste (GP) and G2: CTZ paste (CTZ) for the pulp chamber filling. The radiolucent areas in the furcation region of deciduous molars were obtained from previous x-rays, after 6 and 12 months of the endodontic treatment and was analysed by l Image Tool 3.0 by two blinded examiners. In order to analyse the calibration between the examiners, Kappa test was used and for comparison of the initial radiographic image, analysis of variance was used after 6 and 12 months of each group and Tukey spost-hoc test. T-Student test was used for comparison between groups.RESULTS: There was a reduction of radiolucent area after 6 (p<0.01) and 12 months (p<0.01) in the teeth treated with CTZ paste. In the teeth treated with PG there was not reduction of radiolucent area after 12 months. (p= 0,09).CONCLUSION: Although the clinical signs were similar in both groups after 12 months of follow up, only teeth treated with CTZ showed reduction of radiolucent area in the furca area after 6 and 12 months.

Tratamento Pulpar Indireto em Molares Decíduos em Sessão Única: Estudo Retrospectivo

Resumen pt: Objeti vo: Realizar estudo retrospecti vo por meio de exames radiografi cos de criancas apresentando 21 molares deciduos com cavidades profundas, em fase...