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      Diagnosis of Occlusal Caries with Dynamic Slicing of 3D Optical Coherence Tomography Images

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          Abstract

          Detecting the extent of occlusal caries is a clinically important but challenging task required for treatment decision making. The aim of this study was to assess the diagnostic power of 3D swept-source optical coherence tomography (OCT) for evaluation of occlusal caries in comparison with X-ray radiography. Extracted human molars not exhibiting American Dental Association (ADA) criteria advanced caries were mounted in a silicone block and digital dental radiographs were captured from the buccal side. Subsequently, occlusal surfaces were scanned with a prototype Yoshida Dental OCT. Thirteen examiners evaluated the presence and extent of caries on radiographs and dynamically sliced 3D OCT video images, using a 4 level scale—0: intact; 1: enamel demineralization without cavitation; 2: enamel caries with cavitation; 3: dentin caries with or without cavitation. Sensitivity, specificity and area under operating characteristic curves (Az) were statistically analyzed (α = 0.05). Reliability analysis showed an excellent agreement among the 13 examiners for both methods. The OCT presented a significantly higher sensitivity and Az value for the detection of caries compared to radiographs ( p < 0.05). Radiography showed especially low sensitivity for dentin caries (0–2 versus 3). Dynamic slicing of 3D OCT volumes is a powerful adjunct tool to visual inspection to diagnose the dentin occlusal caries in vitro.

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          Most cited references30

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          The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries.

          This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.
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            The American Dental Association Caries Classification System for clinical practice: a report of the American Dental Association Council on Scientific Affairs.

            The caries lesion, the most commonly observed sign of dental caries disease, is the cumulative result of an imbalance in the dynamic demineralization and remineralization process that causes a net mineral loss over time. A classification system to categorize the location, site of origin, extent, and when possible, activity level of caries lesions consistently over time is necessary to determine which clinical treatments and therapeutic interventions are appropriate to control and treat these lesions.
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              Prevalence of Caries on Individual Tooth Surfaces and its Distribution by Age and Gender in University Clinic Patients

              Objectives: The objectives of the present study were to assess the prevalence rate of caries on individual permanent tooth surfaces, and to compare individual tooth surface caries rates among gender and age groups. Methods: Without drying the teeth, examinations were performed with dental mirrors and blunt, sickle-shaped explorers under a dental chair light, according to WHO recommendations. Results: Caries distribution was higher in the maxillary jaw (62.4%) than in the mandibular jaw (37.6%). Except molars, approximal surfaces of all teeth demonstrated the highest caries rates, ranging from 58.5% to 77.5%. Occlusal fissures on the first and second molars contributed most significantly to caries frequency, from 52.7% to 66.3%. Females (59.1%) showed a higher incidence of caries than males (40.9%). Approximal surfaces of incisors, canines, premolars and occlusal fissure sites in molars showed the highest caries rates in both sexes. Caries were most common among individuals aged 17 to 25 years. Approximal surfaces of incisors, canines, premolars and occlusal surfaces in molars had the highest caries rates in all age groups, except for individuals older than 65 years of age. Conclusions: Gender and age do not affect the prevalence of caries on teeth sites. In addition, more caries are experienced in younger age groups, and their incidence decreases as age increases.
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                Author and article information

                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                17 March 2020
                March 2020
                : 20
                : 6
                : 1659
                Affiliations
                [1 ]Department of Restorative Dentistry, University of Washington, Seattle, WA 98195, USA; mndluong@ 123456uw.edu
                [2 ]Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; yoshiyam@ 123456md.okayama-u.ac.jp
                [3 ]Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo 145-8515, Japan; araki@ 123456dent.showa-u.ac.jp
                [4 ]Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; tagami.ope@ 123456tmd.ac.jp
                Author notes
                Author information
                https://orcid.org/0000-0003-2654-3188
                https://orcid.org/0000-0002-0751-4819
                https://orcid.org/0000-0003-3524-5123
                https://orcid.org/0000-0001-7658-0572
                Article
                sensors-20-01659
                10.3390/s20061659
                7146590
                32192069
                66c455f1-d754-4f63-b289-dcd081c037c2
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 February 2020
                : 14 March 2020
                Categories
                Article

                Biomedical engineering
                dentin,enamel,optical coherence tomography,radiograph,receiver operating characteristic (roc) analysis,hidden caries,dentino-enamel junction dej

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