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Biomedical subjects

E A Kidd

Publications and source records attributed to E A Kidd.

99 records · Page 6Linked to original sources
PubMedDate not supplied

In vitro evaluation of five alternative methods of carious dentine excavation.

This in-vitro, split-tooth study aimed to evaluate the efficiency (time taken) and effectiveness (quantity of dentine removed) of four techniques of carious dentine excavation (bur, air-abrasion, sono-abrasion and Carisolv gel) compared to conventional hand excavation. Eighty freshly extracted human molars were assigned to four experimental groups (n = 20), sectioned longitudinally through occlusal lesions and pre-excavation colour photomicrographs obtained. Using the natural autofluorescence of carious dentine (detected using confocal laser scanning microscopy) as an objective and reproducible guide, carious dentine removal was assessed in each half of the split tooth sample, comparing hand excavation to the test method. The time taken to reach a cavity floor that was hard to a dental probe was noted and final colour photomicrographs were taken. From the results, it was concluded that bur excavation was quickest but overprepared cavities relative to the autofluorescent signature, whereas Carisolv excavation was slowest but removed adequate quantities of tissue. Sono-abrasion tended to underprepare whereas air-abrasion was more comparable to hand excavation in both the time and amounts of dentine removed. Conventional hand excavation appeared to offer the best combination of efficiency and effectiveness for carious dentine excavation within the parameters used in this study.

Air Abrasion, Dental↗
PubMedDate not supplied

A clinical and microbiological study of approximal carious lesions. Part 1: the relationship between cavitation, radiographic lesion depth, the site-specific gingival index and the level of infection of the dentine.

A clinical study was carried out to assess relationship between the presence of approximal cavitation, the radiographic depth of the lesion, the site-specific gingival index and the level of infection of the dentine. Adult patients assessed as needing operative treatment and presenting with approximal lesions visible in the outer third of dentine on bite-wing radiographs were included in the study. Direct lesion depth measurements were recorded from the radiographs and the site-specific gingival index adjacent to the lesion was noted. The presence or absence of a cavity was recorded on an impression following tooth separation. During operative treatment samples of dentine were taken on entry to the lesions to ascertain the level of infection of the dentine. Visual evaluation of 54 successfully recorded impressions revealed that 85% were cavitated. Cavitated lesions were found to have higher site-specific gingival index scores compared to non-cavitated lesions (p = 0.03). The probability of cavitation was greater for lesions >0.5 mm from the enamel-dentine junction on bite-wing radiographs (p<0.01). The level of infection of the dentine was significantly higher for cavitated lesions than for non-cavitated lesions (p = 0.02). However, the non-cavitated lesions were still infected.

Adolescent↗
PubMedDate not supplied

A clinical and microbiological study of approximal carious lesions. Part 2: efficacy of caries removal following tunnel and class II cavity preparations.

A randomized controlled clinical study was set up to assess caries removal following tunnel preparation (test group) and class II cavity preparation (control group). Sixty approximal lesions in adult posterior teeth, visible in the outer third of dentine on bite-wing radiographs, were referred for operative treatment. Initial dentine samples were taken on entry to the lesions in both groups. Following cavity preparation dentine samples were taken from beneath the marginal ridge in the tunnel group and at the cervical floor in both groups. Microbiological analysis was carried out to establish the level of infection of the dentine. The bacterial counts were high on entry to the lesions with a median log10 (CFU + 1) per sample of 3.07 (+/-1.24). Following cavity preparation bacterial counts at the cervical floor were significantly reduced in both amalgam and tunnel groups (p<0.00001). In the tunnel group, however, slightly increased bacterial counts were found beneath the marginal ridge compared to the cervical floor (p<0.01).

Adult↗
PubMedDate not supplied

Comparison between visual examination and a laser fluorescence system for in vivo diagnosis of occlusal caries.

This study compared a laser fluorescence (LF) system (DIAGNOdent) with a visual caries scoring system for in vivo detection and diagnosis of occlusal caries under the conditions of an epidemiological study, in 132 mandibular and 38 maxillary first permanent molars in 170 children (mean age: 6.85 +/- 0.58 years). The teeth were cleaned and occlusal caries status in a selected investigation site recorded using both visual and LF systems. The LF readings were interpreted both according to the cut-off points recommended by the manufacturers and those based on laboratory research with histological validation. The percentage agreement of the LF and visual scoring system was better using the cut-off limits recommended by the manufacturer. Histological validation was not possible in this clinical study, but it appeared that either the LF method was overscoring some lesions or the visual method was underscoring them. Since the LF instrument cannot be expected to differentiate caries from hypomineralisation, it should probably be used as an adjunct to a clinical examination.

Child↗
PubMedDate not supplied

Dentine caries: take it or leave it?

In modern dentistry the primary aim when excavating carious dentine is to eradicate only the highly infected, irreversibly demineralized and denatured biomass in order to allow effective restoration of the cavity, restoration of the surface anatomy of the tooth and to prevent disease progression. However, the boundary between this superficial zone of dentine requiring excavation and the deeper, affected but repairable tissue is not always obvious either in the clinic or in the research laboratory. The inherent subjectivity in detecting this excavation boundary can result in clinically significant differences in the quality and quantity of dentine removed by different operators and makes the in vitro comparison of newer excavation techniques more difficult. This article discusses the rationale behind carious dentine excavation and the criteria available to the dentist, both clinical and laboratory, to help identify the dentine requiring removal.

Bacteria↗