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At least 1,153 records · Page 64Linked to original sources
PubMed1992

An in vitro assessment of the extent of caries under small occlusal cavities.

Many clinicians take for granted that occlusal caries which is just visible as a cavity is extended (deep) into the dentine. This study was aimed at quantifying this opinion. The study was carried out with 60 molars containing small but visible occlusal cavities. After taking bite-wing radiographs the crowns were separated from the roots and embedded. 700-microns sections were cut and glued on plastic sheets. X-ray pictures were taken of the sections which were scored by independent examiners. The bite-wings provided inaccurate estimates of the extent of caries. Radiographs of the sections revealed that about 25% of the molars had caries which reached just to the dentino-enamel junction, while the remaining 75% showed caries extending far into the dentine.

Dental Caries↗
PubMed1992

Validity of probing for fissure caries diagnosis.

One hundred extracted molar teeth with discoloured fissures but without any visible carious cavitation were selected from a large supply, using standardized criteria. The teeth were mounted, placed on a mechanical balance, and probed with a force of 500 g in every fissure, at as many places as possible. Every time the probe was found to stick, the spot was marked. After probing colour slides were made of the occlusal faces. Subsequently, the crowns were embedded in epoxy resin. 700 microns thick sections were cut in a facial-lingual direction with a diamond wheel. From the sections X-rays were taken which were scored as follows: a measuring grid was placed on the X-ray image of a section, and the caries score (0-4) for every millimetre was determined. By scoring every section of a tooth in this way, an overview was obtained of the location of all caries lesions in the occlusal surface. By comparing this overview with the colour slide of the tooth, the relationship between the sticky spots and the lesions was visualized. The results indicate that only 24% of the caries lesions were discovered by probing for stickiness (low sensitivity), but that the probe seldom stuck in a sound fissure (high specificity, > 99%). Probing proved to be unreliable for the diagnosis of fissure caries.

Dental Enamel↗
PubMed1993

Microbiological validation of assessments of caries activity during cavity preparation.

The operative management of primary and secondary caries assumes that all discoloured tissue at the enamel-dentine junction (EDJ) represents active disease and this is removed to arrest the carious process. This study aims to establish clinical criteria to differentiate between active and arrested caries at the EDJ using microbiological assessment of dentine samples to verify its clinical status. Radiographs were available for posterior teeth. Cavities (n = 205) were prepared under rubber dam. After gaining access, areas of the EDJ were chosen and assessments made of consistency (soft, medium, hard), colour (dark brown, mid-brown, pale) and moisture content (wet, dry). Dentine was removed by using a No. 3 round burr and placed in 1 ml of bacteriological culture broth. This sampling procedure was repeated at the same site once during cavity preparation and again when the cavity was judged as fully prepared. Samples were vortexed, diluted and cultured to give viable counts of the total anaerobic microflora, mutans streptococci and lactobacilli; viable counts were expressed as log10 (CFU per sample +1). Results showed no significant differences between the microflora of primary and secondary caries. The number of bacteria recovered diminished significantly as cavities were completed. Initial samples from soft and wet lesions harboured significantly more bacteria, lactobacilli and mutans streptococci than samples from medium, hard or dry lesions. Lesions visible on radiographs harboured more bacteria, including lactobacilli and mutans streptococci, while dentine colour was not discriminatory.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Relationship between external and histologic features of progressive stages of caries in the occlusal fossa.

The material comprised 140 extracted maxillary third molars. The central fossa area was examined with a stereomicroscope (SM) (x16) and macroscopically (M) under standardized conditions after cleaning and air-drying. Signs of caries were classified using a detailed scoring system involving 12 (SM) and 8 (M) classification criteria, ranging from 'sound' to 'cavitation with dentine involvement'. Six radiographic scores were used in the classification. Sections 250 microns in thickness were cut in buccolingual direction through the central fossa, and the fossa section with the most extensive stereomicroscopic changes was selected for histologic examination (x16). The histologic enamel and dentine changes were classified independently using 9 and 7 scores, respectively. The correlation between SM and the histologic enamel changes (HE scores) in terms of progressive demineralization and destruction were highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). The histologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression and the internal enamel and dentine reactions. The data did not support routine usage of radiographic examination for occlusal caries diagnosis.

Adolescent↗
PubMed1995

Grey discolouration and marginal fracture for the diagnosis of secondary caries in molars with occlusal amalgam restorations: an in vitro study.

Grey discolouration of the enamel around a filling and marginal fracture are often reasons to replace restorations due to suspicion of secondary caries. The aim of this study was to establish the validity of grey discolouration and marginal fracture for the diagnosis of caries at the enamel-dentine junction (EDJ) next to an amalgam filling. The occlusal surfaces of 161 extracted molars with occlusal amalgam fillings were photographed on colour slides, from which grey discolourations and marginal fracture were recorded. The size of the fracture was scored using a modified Mahler scale with six categories: score 1 = no marginal fracture (< 30 microns), score 6 = fracture width > 200 microns. Secondary caries at the EDJ was scored on radiographs of 700 micron sections of the molars. Both radiolucencies and radiopacities in dentine were scored as caries. The sensitivity of grey discolouration for detection of secondary caries was 50% and the specificity 91%. The positive and negative predictive values were 71 and 80%, respectively. Marginal fracture was evaluated at five different levels of severity. Although there was caries present more frequently at the EDJ under severely fractured margins, marginal fracture was found of little diagnostic value at all levels. Only marginal fracture at threshold level V provided a positive predictive value (50%), which was significantly higher than the caries prevalence (31%). It is concluded that width of marginal fracture, as defined by the Mahler scale, has hardly any value for the diagnosis of secondary caries. However, grey discolouration may be a useful diagnostic aid.

Color↗
PubMed1997

The effect of chlorhexidine/xylitol chewing-gum on cariogenic salivary microflora: a clinical trial in elderly patients.

The effects of 14-day use of either a chlorhexidine/xylitol or a xylitol chewing gum on salivary levels of mutans streptococci, lactobacilli, and yeasts were determined for 53 subjects (mean age 79.49 +/- 7.7 years) participating in this randomised, double-blind, placebo-controlled trial. Salivary flow rates and enamel staining were measured and the attitudes of the subjects to gum chewing were evaluated by the use of structured questionnaires. The chlorhexidine/xylitol gum significantly reduced the salivary levels of mutans streptococci (p < 0.0001) lactobacilli (p < 0.05) and yeasts (p < 0.05) while the xylitol placebo gum produced significant reductions in mutans streptococci (p < 0.01) only. The study population found chewing gum twice per day for 10 min an acceptable method of receiving medication and improving oral health. Prior to gum use participants recognised persistent symptoms of dry mouth and their subjective evaluation of dry mouth was significantly (p < 0.001) related to the number of prescribed medications with xerostomic side-effects. The desire to continue gum use was significantly related to the subjects' evaluation of their oral dryness at baseline and to their perceived oral health gain from gum usage. Only those participants with stained enamel at baseline exhibited increased enamel staining following chlorhexidine/xylitol gum usage.

Aged↗
PubMed1997

Wavelength-dependent fibre-optic transillumination of small approximal caries lesions: the use of a dye, and a comparison to bitewing radiography.

The mere detection of caries lesions is insufficient for optimal treatment decision-making. Hence, the aim of this study was to investigate whether quantitative information about approximal lesion depth can be obtained from a technique based on the wavelength dependency of light propagation and additional use of a dye. Another aim was to compare the diagnostic performance of the optical technique and bitewing radiography. Measurements were performed on 33 extracted premolar teeth. Twelve proximal surfaces had white-spot, and 17 had discoloured small lesions. Four surfaces were sound. The teeth were transilluminated with a single glass fibre at the approximal surface before and after dye application. The occlusal surface was imaged with a CCD camera. Light in the blue and red part of the electromagnetic spectrum was selected using Schott glass filters. Average decadic optical thickness differences, delta bl-rd tau eff, were estimated and plotted as a function of normalised lesion depth, dhist, established from histological validation by two observers. The Spearman rank correlation was rs (delta bl-rd tau eff, dhist) = 0.87 (95% confidence interval, CI: 0.74-0.94). A marked increase in average decadic optical thickness in the blue part of the electromagnetic spectrum, delta dye tau eff, was observed for those lesion that, upon direct visual inspection of the approximal surface, clearly showed dye uptake. Bitewing radiographic depth ratings of two observers were plotted as a function of dhist. The correlations were rs (dRA,1, dhist) = 0.62 (95% CI: 0.34-0.80), rs (dRA,2, dhist) = 0.75 (95% CI: 0.54-0.87), and between the observers rs (dRA,1, dRA,2) = 0.44 (95% CI: 0.10-0.69). The p values of rs (delta bl-rd tau eff, dhist) -rs (dRA1,1, dhist) and rs (delta bl-rd tau eff, dhist) -rs (dRA,2, dhist) were p1 = 0.01 and p2 = 0.08, respectively. It was concluded that quantitative information about lesion depth can be obtained optically. The dye penetrates into only a limited number of caries lesions, in which cases dye uptake is detectable in transillumination geometry. Under laboratory circumstances the optical technique performs as well as bitewing radiography in the diagnosis of small approximal caries lesions.

Bicuspid↗
PubMed2001

Oral health status and oral health behaviors in Chinese Children.

The objectives of the study were to describe the oral health status and treatment needs of the 5- to 6-year-old and 12-year-old children in Southern China; to describe the patterns of oral health behaviors, knowledge, and attitudes among the 12-year-olds; and to assess the effects of socio-behavioral factors on the 12-year-old children's dental caries experiences. The study sample was comprised of 1,587 5- to 6-year-old and 1,576 12-year-old urban and rural schoolchildren living in Guangdong Province. Three calibrated dentists clinically examined the children, and trained interviewers interviewed the 12-year-olds. Caries prevalence of the 5- to 6-year-old children was high (urban 78% vs. rural 86%); the mean dmft of the urban and rural children was 4.8 and 7.0, respectively. The caries prevalence and mean DMFT score of the 12-year-olds were 41% and 0.9 (urban) and 42% and 0.9 (rural). Only 2% of the 12-year-olds exhibited no calculus or gingival bleeding, while more than 70% had calculus. In conclusion, there is an urgent need for establishing caries-preventive activities for preschool children. The prevalence of caries among the 12-year-olds was not high, but their periodontal condition was unsatisfactory. Knowledge about gum bleeding and the use of fluoride was low. More oral health education activities should be organized, especially for the rural children.

Analysis of Variance↗