The aim of this study was to evaluate whether there is any difference in the diagnostic information provided by conventional two-dimensional (2D) images or by three-dimensional (3D) cone beam computed tomography (CBCT) in subjects with unerupted maxillary canines. Twenty-seven patients (17 females and 10 males, mean age 11.8 years) undergoing orthodontic treatment with 39 impacted or retained maxillary canines were included. For each canine, two different digital image sets were obtained: (1) A 2D image set including a panoramic radiograph, a lateral cephalogram, and the available periapical radiographs with different projections and (2) A 3D image set obtained with CBCT. Both sets of images were submitted, in a single-blind randomized order, to eight dentists. A questionnaire was used to assess the position of the canine, the presence of root resorption, the difficulty of the case, treatment choice options, and the quality of the images. Data analysis was performed using the McNemar-Bowker test for paired data, Kappa statistics, and paired t-tests. The findings demonstrated a difference in the localization of the impacted canines between the two techniques, which can be explained by factors affecting the conventional 2D radiographs such as distortion, magnification, and superimposition of anatomical structures situated in different planes of space. The increased precision in the localization of the canines and the improved estimation of the space conditions in the arch obtained with CBCT resulted in a difference in diagnosis and treatment planning towards a more clinically orientated approach.

In this article, the fundamentals of caries diagnosis are reviewed from the three component perspectives, namely the strategy, the logics, and the tactics. Strategy concerns the objectives of the diagnostic process (i.e. why we diagnose caries). The logics describe how we assemble and evaluate the information collected and how this leads to an assessment of diagnostic value. Finally, tactics are about how we collect the information necessary to arrive at a correct diagnosis. We argue that the hitherto-dominant essentialistic caries paradigm should be replaced by a nominalistic caries concept. This allows us to circumvent the problem of a lack of a caries gold standard and to proceed in caries-diagnostic research to find the diagnostic methods that result in the best health outcomes for our patients. We also demonstrate the limitations of the medical model when attempting to understand caries diagnosis, and adhere to the Bader & Shugars caries script model. It is concluded that the current caries profile, characterized by lower prevalence and extent, and slower progression, has increased the need for an academic strengthening of the dental curriculum with respect to diagnostic reasoning and clinical decision-making processes.

No abstract

The eruption mechanism is not fully understood. It is known that the dental follicle is essential and that experimentally provoked denervation influence the process of eruption. Accordingly, the purpose of this study was to elucidate the eruption pattern in a human population and relate this pattern to the pattern of jaw innervation. The eruption pattern was evaluated from the correlation between the emergence times of different teeth in the permanent dentition based on longitudinal data from a large national registry (12,642 boys and 12,095 girls). Correlations coefficients were generally high (>0.5) and higher between teeth within the same tooth groups (i.e. incisors, canines and premolars, and molars) than between teeth from different tooth groups. It was shown that the correlation in emergence of teeth closely followed the pattern of innervation of the jaws. Thus the study supported the hypothesis concerning a possible association between eruption and innervation.

Our aim was to identify determinants of utilization of dental services among 20- to 34-year-old Danes as outlined in a conceptual framework. Our sample consisted of a sample of 464 individuals who had been interviewed by 10 experienced interviewers from The Danish National Institute of Social Research. Our questionnaire comprised a battery of questions based on our conceptual model. The analysis was done in a hierarchical manner using a framework with three steps: Predisposing factors --> Enabling factors --> Need factors --> Utilization. Associations were evaluated with multivariate logistic regression analysis and expressed as odds ratios. The following factors were significantly associated with irregular use of dental services: age, sex, exercise habits, cost of dental treatment, dental anxiety, and perceived condition of teeth. Our findings suggest that a strategy aiming to increase young people's dental attendance should focus on the transition period that is, when the youngsters leave the public dental health care system and have to make use of the private system. The strategy should also take into account that young men are more likely to become non-users. A concerted effort could be dedicated to the non-negligible group of individuals with dental anxiety and dental phobia.

The influx of refugees from Vietnam to the industrialized countries has attracted a certain interest to studies describing the oral health status of these population groups. The present study comprises 361 refugees arriving in Malaysia from Vietnam and collected immediately at the refugee camp on Pulau Bidong. Dental caries, calculus, gingival bleeding and loss of periodontal attachment were recorded. Mean dmft increased from 1.3 for 0-2-yr-olds to 7.4 for 3-5-yr-olds. For 6-9-yr-olds mean DMFT was 2.4 while it ranged between 8.5 and 10.10 for the older age groups. The frequency of secondary lesions was high for all age groups. Calculus increased consistently with age, while gingival bleeding was common even in the youngest age group. Loss of periodontal attachment greater than or equal to 6 mm was rare in all age groups except the oldest (45 yr or older). A strategy for oral health care for these population groups is discussed.

Two cohorts of 17-yr-olds treated in a municipal child dental service in 1978-79 and 1984-85 had bitewing radiographs taken at the examination before the last course of treatment in the service. All radiographs were read by one examiner, who did not know to which cohort the individual belonged. The subsequent treatment was recorded from the treatment records by another examiner, who was unaware of the results of the radiographic examination. According to radiographic scores, the proportion of decayed or filled (DFS) approximal surfaces had decreased from 23.2% to 17.4% during the period (difference: 25%). The proportion of unfilled surfaces which were decayed (DS) had remained almost constant, while 9.6% of the surfaces were filled (FS) in 1978-79 compared to 3.1% in 1984-85 (difference: 68%). Thus, in spite of a 25% decrease in total caries experience (DFS), a reduction of 68% would be claimed if fillings (FS) were interpreted as expression of disease prevalence. The risk of an approximal surface being filled decreased to about one fifth from 1978-79 to 1984-85, and the risk of being filled was nearly three times as high for approximal surfaces of children who already had approximal fillings at the time of examination. Thus, both the year of examination and the subject's previously received treatment seemed to influence the treatment strategy of the dentist.

The caries-preventive effect of Duraphat® lacquer versus fluoride mouthrinses was evaluated in a 5-year clinical trial. The lacquer group received Duraphat application every 6th month and a placebo rinse every 2nd week during the school year. The fluoride rinse group received a 0.2% sodium fluoride rinse every 2nd week during the school year and a placebo lacquer every 6th month. All children received regular dental examination and treatment in clinics established by the municipality in which the study took place. Fluoride content of the drinking water varied between 0.1 and 0.2 ppm F^––. Caries was recorded clinically and radiographically and increments calculated after 3 and 5 years. On teeth erupted at baseline the clinical caries increment after 5 years was 2.96 DMF-S in the lacquer group and 2.77 DMF-S in the fluoride rinse group, evaluated for the 248 3rd grades completing the study. Caries increment in teeth erupting during the trial was 2.20 DMF-S in the lacquer group and 2.30 DMF-S in the fluoride rinse group. The corresponding figures for radiographic caries increment were 1,01 and 0.82 DMF-S for teeth erupted at baseline, and 0.59 and 0.45 DMF-S for teeth erupting during the trial. None of the differences were statistically significant. Mean time needed to apply the lacquer was approximately 4 min, when working with a chairside assistant and 6 min, when working without a chairside assistant.