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Biomedical subjects

E A Kidd

Publications and source records attributed to E A Kidd.

At least 73 records · Page 4Linked to original sources

A reappraisal of the value of the bitewing radiograph in the diagnosis of posterior approximal caries.

The aim of this paper was to re-assess the available literature examining the value of the bitewing radiograph in the diagnosis of approximal caries and to compare the relative values of radiographic and clinical examinations. To this end, results from 29 research studies have been re-presented and tabulated. These results show that the use of the bitewing radiograph is essential if much approximal caries is not to be missed. It is particularly important in the detection of the small lesion which may be managed preventively rather than operatively. Although there is a proper need to ensure that radiographic exposures are minimised, the evidence suggests that both clinicians and epidemiologists must balance this need with the ethical issues associated with failing to employ an established diagnostic aid.

Bicuspid↗

The caries status of occlusal amalgam restorations with marginal defects.

The purpose of this study was to examine histologically occlusal amalgam restorations with both defective and sound margins for comparison of their caries status. Thirty extracted teeth with occlusal amalgam restorations were sectioned so that a ditched and a clinically sound margin could be examined on the same tooth in the mouth. Histological examination showed a low prevalence of caries lesions in the outer enamel. However, lesions were present in the enamel of the cavity wall in 54% of specimens, whether the margin was defective or sound. If the results of this study are applicable to all occlusal amalgams with defective margins, it would appear that a defective margin alone is not an indication that a restoration needs to be replaced.

Dental Amalgam↗

Caries diagnosis within restored teeth.

Secondary caries is the most common reason given by dentists for the replacement of restorations, and yet this is a diagnosis that is difficult to make with confidence. This paper attempts to define some of the problems in the diagnosis of caries in restored teeth. The histology of the secondary carious lesion shows that it may be considered in two parts: an outer lesion adjacent to the filling, and a wall lesion which will occur only if there is leakage between the filling and the tooth. The specific diagnostic difficulties addressed are the difficulty of seeing this wall lesion, whether a defective margin indicates secondary caries, and the difficulties of differentiating secondary from residual caries and active from arrested disease. Since further research is needed to solve many of these problems, the paper ends by discussing the consequences of these difficulties for clinicians, epidemiologists, teachers, and research workers.

Dental Caries↗

Staining of residual caries under freshly-packed amalgam restorations exposed to tea/chlorhexidine in vitro.

Discoloration around restorations may lead practitioners to suspect recurrent caries. Dentists, using conventional optical and tactile criteria, often fail to render the enamel-dentine junction completely caries-free during cavity preparation. The aim of the present laboratory study was to test the hypothesis that such residual caries could take up stain from tea and hence affect clinical judgement on the presence of recurrent disease. Cavities were prepared in freshly extracted carious teeth and restored with amalgam. Specimens were then temperature cycled in tea and chlorhexidine or in tea alone to encourage leakage. Subsequent removal of restorations showed staining of parts of the enamel-dentine junctions and histological examination showed these stained areas to correspond to areas of demineralization. Similarly prepared caries-free teeth showed no such staining. Thus residual caries in teeth with leaking restorations can, in the laboratory, take up stain. If this were to happen in vivo, stained residual caries could subsequently be misdiagnosed as recurrent caries.

Chlorhexidine↗

The use of a caries detector dye in cavity preparation.

The aim of this study was to compare the conventional visual and tactile method of detecting carious dentine during cavity preparation using a mirror, probe and excavator with a visual method enhanced by a dye. The dye, 1% acid red in propylene glycol, was used on 100 cavities prepared by dental students and passed as clinically satisfactory by their teachers. Results showed dye stain at the enamel-dentine junction in 57 cavities (57%) which had been assessed as caries-free in this area using conventional visual and tactile means. Subsequent laboratory work on extracted carious teeth confirmed histologically that the dye stains demineralised dentine. If clinicians consider it important to render the enamel-dentine junction caries-free, it might be prudent to use the dye as an aid to diagnosis in this area.

Coloring Agents↗

Root caries.

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Dental Caries↗