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    Clinical outcomes of selective removal to soft dentin versus firm dentin for deep caries lesions: a randomized controlled trial up to 5 years
    (2024) Gözetici Çil, Burcu; Çetin, Tuba; Bittar, Ahmad; Özcan, Mutlu
    Objectives: This study aimed to compare the success of selective removal to soft dentine (SRSD) with or without calcium silicate (CS) and selective removal to firm dentine (SRFD) in permanent dentition. Materials and methods: Between November 2018 and March 2020, 165 posterior deep caries lesions in 134 patients were included in the study and randomly assigned into test (n = 101) and control (n = 64) groups. The control group (n = 46) received the treatment of SRFD with CS, while the test group was further randomized into two groups to receive SRSD with CS (n = 45) and SRSD without CS (n = 45). An additional group (PE) consisted of teeth with exposed pulps during caries removal (n = 29). The primary outcome of the study was to assess the vitality of the teeth based on clinical and radiographic examination after five years. The secondary outcome of the study was to evaluate the influence of baseline variables and CS application on treatment outcome. The success rates of different treatment strategies were compared (Pearson chi-squared and Log-rank tests). The impact of baseline variables and treatment strategies on failure and dentin bridge formation was analyzed using binary logistic regression model. Results: The success rate for SRSD with or without CS (94.1–100%) was significantly higher compared to SRFD (75.8%) and PE (81.8%) after five years (P = 0.012). Failure was less likely for premolars. Cavity type and depth had an influence on dentin bridge formation. Conclusion: A five-year follow-up in this study demonstrated better clinical outcome for SRSD with or without CS compared to SRFD technique, irrespective of age, pre-op sensitivity, cavity type, radiographic depth and activity of the caries. Application of CS after SRSD in deeper cavities provided better healing in terms of dentin bridge formation. Clinical relevance: SRSD might be more advantageous over SRFD for the management of deep caries lesions.
  • Küçük Resim
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    Validity assessment of a third-generation light-induced fluorescence device in detecting proximal and occlusal caries lesions: a cross-sectional study
    (2024) Bittar, Ahmad; Çetin, Tuba; Başyiğit, Gizem Meva; Gözetici Çil, Burcu
    Objectives: The objective of this study was to evaluate the efficacy of a quantitative light-induced fluorescence (QLF) device (QrayCam Pro, AIOBIO, Seoul, Republic of Korea) in detecting and differentiating the severity of posterior proximal and occlusal primary caries. Materials and methods: The study included a total of 120 teeth in 60 patients (of both genders, aged between 21 and 38 years) between January and March 2024, one carious tooth and one sound tooth were selected at random in each patient. All occlusal surfaces were evaluated in accordance with the International Caries Detection and Assessment System (ICDAS) Nyvad Criteria, using the visual tactile method. The ICDAS employs a scoring system ranging from 0 to 6, while the Nyvad Criteria employs a similar scoring system. Addionally, the depth of the proximal lesions was scored (0–6) using bite-wing radiography. The quantitative values representing the maximum loss of fluorescence (∆Fmax) and the maximum change in the ratio of red and green fluorescence (∆Rmax) were obtained using the Q-ray Clinical software v 1.45. To assess the validity, the sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) were calculated. Spearman correlation coefficient was used to investigate the correlation between the findings of the traditional and QLF examination methods. Results: The AUROC values for both ∆Fmax and ∆Rmax were found to be excellent. The sensitivity of QrayCam Pro was found to be 84–88.6%, while the specificity was 100%. The correlation analysis demonstrated a strong correlation between scores obtained from the traditional examination and the QLF values. Conclusions: Based on the findings of this study, QrayCam Pro exhibits potential as a valuable additional tool for not only detecting caries but also for assessing their severity and activity. Clinical relevance: This study revealed that QrayCam Pro might be suggested as a precise tool for enhancing caries detection and assessment compared to traditional methods. By providing quantitative data on caries severity and activity, it enables more informed treatment decisions, potentially optimizing outcomes for patients.