Objectives: Adhesion and marginal adaptation of a claimed bioactive restorative material (ACTIVA BioACTIVE Restorative) to human teeth were compared with those of a resin-modified glass ionomer cement (Fuji II LC) and a control resin composite (Ceram X Mono). Material and Methods: Shear bond strength and marginal adaptation to enamel and dentine were assessed after no pretreatment of the hard tissues or after etching with phosphoric acid (ACTIVA BioACTIVE Restorative and Ceram X Mono) or polyacrylic acid (Fuji II LC). For ACTIVA BioACTIVE Restorative, the effect of applying a self-etch adhesive (Xeno Select, Dentsply Sirona) was also investigated. Data were analyzed using non-parametric tests (a ¼ 0.05). Results: Bond strength and marginal adaptation in enamel and dentine were significantly different among the investigated materials (p<.05). Due to loss of restorations, it was not possible to measure bond strength of ACTIVA BioACTIVE Restorative if no pretreatment was performed or if dentine was etched; however, use of the self-etch adhesive resulted in similar bond strength as Ceram X Mono. Etching improved adhesion of Fuji II LC to enamel and dentine. Regarding marginal adaptation, ACTIVA BioACTIVE Restorative showed the highest wall-to-wall contraction to enamel in all pretreatment groups and the overall highest wall-to-wall contraction to dentine after etching. Due to loss of restorations, no marginal assessment was possible on cavities with margins in dentine when no pretreatment was used. The use of a self-etch adhesive with ACTIVA BioACTIVE Restorative resulted in similar adaptation to dentine compared to the other materials. Conclusion: The self-adhesive property of ACTIVA BioACTIVE Restorative is nonexistent.

<b><i>Objectives:</i></b> To develop an automated fluorescence-based caries scoring system for an intraoral scanner and to<i></i>test the performance of the system compared to state-of-the-art methods. <b><i>Methods:</i></b> Seventy-three permanent posterior teeth were scanned with a three-dimensional (3D) intraoral scanner prototype which emitted light at 415 nm. An overlay representing the fluorescence signal from the tissue was mapped onto 3D models of the teeth. Multiple examination sites (<i>n</i> = 139) on the occlusal surfaces were chosen, and their red and green fluorescence signal components were extracted. These components were used to calculate 4 mathematical functions upon which a caries scoring system for the scanner prototype could be based. Visual-tactile (International Caries Detection and Assessment System, ICDAS), radiographic (ICDAS), and histological assessments were conducted on the same examination sites. <b><i>Results:</i></b> Most index tests showed significant correlation with histology. The strongest correlation was observed for the visual-tactile examination (<i>r</i>_s = 0.80) followed by the scanner supported by the caries classification function that quantifies the overall fluorescence compared to sound surfaces (<i>r</i>_s = 0.78). Additionally, this function resulted in the highest intra-examiner reliability (κ = 0.964), and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60–1.84) at the 2 histological levels where the comparison with visual-tactile assessment was possible (κ = 0.886, sum SE-SP = 1.57–1.81) and at the 3 out of 4 histological levels where the comparison with radiographic assessment was possible (κ = 0.911, sum SE-SP = 1.37–1.78); the only exception was for the lesions in the outer third of dentin, where the radiographic assessment showed the highest sum SE-SP (1.78). <b><i>Conclusion:</i></b> A fluorescence-based caries scoring system was developed for the intraoral scanner showing promising performance compared to state-of-the-art caries detection methods. The intraoral scanner accompanied by an automated caries scoring system may improve objective caries detection and increase the efficiency and effectiveness of oral examinations. Furthermore, this device has the potential to support reliable monitoring of early caries lesions.

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Objectives: To assess the feasibility of detecting and monitoring early erosive tooth wear using a 3D intraoral scanner (IOS) aided by specific software. Methods: Extracted sound permanent teeth were assembled in two shortened artificial dental arches and scanned at different intervals with an IOS (3Shape TRIOS® 3) before and after an erosion/abrasion protocol (i.e. 1 h up to 24 h immersion in citric acid solution and subsequent brushing). The 3D models obtained at consecutive time points were superimposed with the baseline model using dedicated software (3Shape TRIOS® Patient Monitoring, version 2.1.1.0) and reference surface alignment. Surface profile differences between the baseline 3D model and the respective models from different time points were expressed as tooth substance loss. Non-parametric tests were used to assess the significance of tooth substance loss at different time points. Spearman's correlation was applied between the tooth substance loss at the end of each erosion/abrasion cycle and the immersion time in acid. Results: Significant tooth substance loss (0.08 mm, IQR=0.05) was detected by the software after 3 h of erosive-abrasive challenge (p=0.045). The overall median loss increased gradually from baseline to 24 h showing a strong correlation with the immersion time in acid (rs=0.971, p<0.01). Conclusions: The use of an IOS aided by specific software showed good performance for early detection and monitoring of tooth wear in vitro and has promising potential for in vivo application. Clinical significance: Detection and monitoring of early erosive tooth wear can be reliably aided by intraoral scanning supported by specific software. The measurement error and uncertainty involved in this method should be taken into consideration when interpreting the tooth substance loss measurements. Furthermore, presuming the difficulty in defining reference surfaces in vivo, clinical validation is needed to determine the system's in vivo performance.

Summary Background The potential of non‐invasive optical coherence tomography (OCT) as a tool for assessment of fit of indirect reconstructions is not fully explored. Objectives The objectives were to investigate the feasibility and validity of OCT, and to measure the internal and marginal fit of acrylic bridges fabricated using direct and indirect digitalisation. Methods The accuracy of the employed swept source OCT (wavelength: 1310 nm) was assessed by comparing with an object with known dimensions. Validity was assessed by measuring an OCT measurements on replica, mimicking the cement film thickness, with stereomicroscopic measurements. The reconstructions were placed on the abutments without cementation. The internal and marginal fit of acrylic bridges from direct and indirect digitalisation techniques were then assessed by obtaining 5 OCT B‐scans per abutment tooth at pre‐defined positions located 250 μm apart. The marginal and internal cement gaps were measured using image‐processing software (ImageJ). Mean and standard deviation were calculated for both groups and t test assuming unequal variances was carried out. The level of significance was defined at 0.05. Results A strong linear correlation (r = 0.865) between OCT and stereomicroscopy was found. T test showed significantly (P < 0.01) better internal fit of bridges made from indirect digitalisation, but no difference in marginal fit. Conclusion OCT is a feasible and valid tool for investigating internal and marginal fit of acrylic dental reconstructions. Better internal fit was observed in bridges fabricated using the direct digitalisation technique. No difference in marginal fit was found between the two fabrication methods.

Aim This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. Material and methods PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. Results From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81–0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. Conclusion The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. Clinical relevance BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.

The use of 3D intraoral scanners (IOS) and software that can support automated detection and objective monitoring of oral diseases such as caries, tooth wear or periodontal diseases, is increasingly receiving attention from researchers and industry. This study clinically validates an automated caries scoring system for occlusal caries detection and classification, previously defined for an IOS system featuring fluorescence (TRIOS 4, 3Shape TRIOS A/S, Denmark). Four algorithms (ALG1, ALG2, ALG3, ALG4) are assessed for the IOS; the first three are based only on fluorescence information, while ALG4 also takes into account the tooth color information. The diagnostic performance of these automated algorithms is compared with the diagnostic performance of the clinical visual examination, while histological assessment is used as reference. Additionally, possible differences between in vitro and in vivo diagnostic performance of the IOS system are investigated. The algorithms show comparable in vivo diagnostic performance to the visual examination with no significant difference in the area under the ROC curves ($$p>0.05$$ p > 0.05 ). Only minor differences between their in vitro and in vivo diagnostic performance are noted but no significant differences in the area under the ROC curves, ($$p>0.05$$ p > 0.05 ). This novel IOS system exhibits encouraging performance for clinical application on occlusal caries detection and classification. Different approaches can be investigated for possible optimization of the system.

Aim This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.