Background This systematic review summarizes the prevalence of dental defects after chemo and radiation therapy and correlates the findings with specific characteristics of each treatment modality. Methods Database search was performed for studies reporting dental late effects of chemo and radiation therapy. After data extraction and risk of bias assessment, prevalence of crown and root defects was assessed. Correlations between each defect and the characteristics of the antineoplastic treatment were performed. Results Sixteen nonrandomized studies were included, yielding a total of 1300 patients with a mean age at diagnosis of 4.5 years. Results reported that root defects were more common than crown defects. The most common root defect was impaired root growth and microdontia the most common crown defect. Age, radiation dose and field were statistically associated with higher prevalence of dental defects. Conclusion Defects were associated with combination of chemotherapy and radiotherapy, as used in current therapeutic antineoplastic modalities.
Laser/light fluorescence devices were highly reliable for occlusal caries diagnosis in permanent teeth but not superior in accuracy to visual methods. SUMMARYPurpose: Current caries diagnostic tools are neither very accurate nor very reliable for the detection of carious lesions of different depths. Thus, the development of new devices and techniques is needed. The aim of this in vitro study was to validate a newer fluorescence device, VistaProof (VP), and compare it with DIAGNOdent Pen (DP), direct visual (DV) and indirect visual methods (IDV), with respect to accuracy and reliability for the detection of occlusal caries in permanent teeth.Methods and Materials: One hundred seven sites on 41 occlusal surfaces of recently extracted premolars were selected and classified into lesion categories according to Ekstrand's clinical criteria, by direct and indirect visual examination. The fluorescence of the sites was also measured by the two devices, and the teeth were ground through the sites for histological evaluation of their lesion depth. One calibrated examiner of high reliability (intraclass correlation coefficient [ICC].0.85) made all of the evaluations. Sensitivity, specificity, and accuracy of each detection method were estimated based on histological examination as the reference method, estimated using cutoff limits calculated on the basis of best agreement between the devices' values and histological examination. McNemar tests and receiver operating characteristic (ROC) curve , 2012, 37-3, 234-245 analyses were used to compare the validity measures of all detection methods at a=0.05, while the ICC was used to test the reproducibility of the methods based on a second measurement one week after the first.Results: There was no statistically significant difference (p.0.05) between the accuracy of DP and VPs for both enamel and dentin lesions. The areas under the ROC curves (AUC) for the two devices were also found not to be different (p.0.05). The reliability of DP was statistically significantly better than VP (p,0.05).Conclusion: The validity of both fluorescence devices were not found to be significantly different and not better than visual methods for the detection of noncavitated carious lesions.
Background: Dental anomalies are common late side effects of childhood cancer therapy and may lead to anatomical, functional, and aesthetic sequelae. Aim: The study aimed to record dental late effects of antineoplastic treatment and associate them with disease and treatment characteristics in order to identify possible risk factors. Design: Orthopantomograms of 70 survivors aged 4-21 years, who were treated at ages 0-10 years for any type of malignancy and completed antineoplastic treatment at least one year before, were examined. Incidence of developmental disturbances was recorded. Their severity was calculated, and odds ratios for the development of severe defects were estimated. Results: Root defects presented in 62% of the participants, with impaired root growth being the most common (58%). Increased incidence was associated with combination treatment protocols, irradiation to the head and neck region, and administration of antimetabolites, steroids, and vincristine. Mean DeI value was 17.46 with risk factors for the development of severe root defects being diagnosis of acute lymphoblastic leukemia, combination treatment protocols, administration of cyclophosphamide and steroids, and hemopoietic stem cell transplantation. Conclusions: Root defects are common among childhood cancer survivors, with their incidence and severity being affected by multiple disease and treatment characteristics. K E Y W O R D S childhood cancer survivorss, dental late effects, radiographic findings, root defects Why this paper is important to paediatric dentists?• Chemotherapy and radiotherapy can have a negative effect on healthy tissues as they lack specificity, with the percentage of children that present with at least one late effect in any organ increasing dramatically.• Dental anomalies are among the common long-term side effects of childhood cancer therapy that may cause anatomical, functional and aesthetic sequelae and impact on the quality of life of both the patients and their caregivers. • Alterations in the shape and the development of the root are prominent with its incidence and severity being affected by specific disease and treatment characteristics. c statistical significance P < .05 using chi-square. d statistical significance P < .10 using chi-square.Grey shades are for highlighting subgroups with significance of the size of the effect.
The validity of DIAGNOdent Pen™ and Vista Proof™ for the chairside diagnosis and quantification of non-cavitated WSL in orthodontic patients was moderate, and no better as compared to the visual diagnostic methods. The fluorescence devices performed similarly to the visual examination for more extended WSL and poorer for milder ones. Validity between the two devices did not differ.
Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the ‘corrected covered area’ (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.
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