Tests to detect and inform the diagnosis of root caries

Fee, Patrick A; Macey, Richard; Walsh, Tanya; Clarkson, Jan E; Ricketts, David

doi:10.1002/14651858.cd013806

Cited by 9 publications

(12 citation statements)

References 98 publications

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“…The use of different diagnostic criteria to define root caries within published risk models presents challenges in comparing the performance of these models. Agreement on the clinical criteria used to define root caries is needed to promote consistent reporting between studies [Ritter et al, 2010;Hayes et al, 2017;Fee et al, 2020]. This study relied on visual-tactile examination alone to detect root caries lesions.…”

Section: Discussionmentioning

confidence: 99%

Development of a Root Caries Prediction Model in a Population of Dental Attenders

et al. 2022

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Root caries prevalence is increasing as populations age and retain more of their natural dentition. However, there is generally no accepted practice to identify individuals at risk of disease. There is a need for the development of a root caries prediction model to support clinicians to guide targeted prevention strategies. The aim of this study was to develop a prediction model for root caries in a population of regular dental attenders. Clinical and patient-reported predictors were collected at baseline by routine clinical examination and patient questionnaires. Clinical examinations were conducted at the four-year timepoint by trained outcome assessors blind to baseline data to record root caries data at two thresholds - root caries present on any teeth (RC>0), and root caries present on three or more teeth (RC≥3). Multiple logistic regression analyses were performed with the number of participants with root caries at each outcome threshold utilised as the outcome and baseline predictors as the candidate predictors. An automatic backwards elimination process was conducted to select predictors for the final model at each threshold. The sensitivity, specificity and c-statistic of each model's performance was assessed. A total of 1432 patient participants were included within this prediction model, with 324 (22.6%) presenting with at least one root caries lesion, and 97 (6.8%) with lesions on three or more teeth. The final prediction model at the RC>0 threshold included increasing age, having ≥9 restored teeth at baseline, smoking, lack of knowledge of spitting toothpaste without rinsing following toothbrushing, decreasing dental anxiety and worsening OHRQoL. The model sensitivity was 71.4%, specificity 69.5% and c-statistic 0.79 (95% CI 0.76, 0.81). The predictors included in the final prediction model at the RC≥3 threshold included increasing age, smoking and lack of knowledge of spitting toothpaste without rinsing following toothbrushing. The model sensitivity was 76.5%, specificity 73.6% and c-statistic 0.81 (95% CI 0.77, 0.86). To the authors’ knowledge this is the largest published root caries prediction model, with statistics indicating good model fit and providing confidence in its robustness. The performance of the risk model indicates that adults at risk of developing root caries can be accurately identified, with superior performance in the identification of adults at risk of multiple lesions.

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Section: Discussionmentioning

confidence: 99%

Development of a Root Caries Prediction Model in a Population of Dental Attenders

et al. 2022

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“…Cellular (clastic) resorption within the oral cavity is rare, but it does occur with trauma-related cervical resorption near the gingival margin [112]. These often extensive lesions may be mistaken for root caries in a clinical or radiographic evaluation [112,128]. The etiology of cervical resorption is probably an immunologic response to injury [129] rather than erosion, abfraction, or caries [35, 36, 104, 127••].…”

Section: Pathologic Perspectivesmentioning

confidence: 99%

“…The etiology of cervical resorption is probably an immunologic response to injury [129] rather than erosion, abfraction, or caries [35, 36, 104, 127••]. Teeth may appear discolored for many reasons including white spot formation, yellowing of enamel, root caries, cervical erosion, pulp necrosis, and/or the extensive secondary dentin formation with aging [104,111,128,130].…”

Section: Pathologic Perspectivesmentioning

confidence: 99%

“…Medication-related oral necrosis of the jaw (MRONJ) results in exposed oral bone sequestra [131]. Under the influence of resorption-suppressing medications, e.g., bisphosphonates and denosumab, large sections of oral bone may die and hypermineralize to form a sequestrum particularly in areas of osseous infection [128]. Subsequently, compromised mucosa covering the nonvital sequestrum atrophies because there is no vascular supply traversing the dead bone, thereby exposing an MRONJ lesion in the oral cavity.…”

Section: Pathologic Perspectivesmentioning

confidence: 99%

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Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions

Roberts

Mangum

Schneider

2022

Curr Osteoporos Rep

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Purpose of the Review Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. Recent Findings Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Summary Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.

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“…e DTA systematic review [39] of the DTA studies in dentistry tried to point out that the increase in sensitivity of the index test was prone to be associated with a disease prevalence of the study population.…”

Section: Strength and Limitations Of The Reviewmentioning

confidence: 99%

Diagnostic Accuracy of CBCT for Detection of Second Canal of Permanent Teeth: A Systematic Review and Meta-Analysis

Aung

Myint

2021

International Journal of Dentistry

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Introduction. Missed canal is one of the common reasons for nonsurgical endodontic retreatments. The missed canals were frequently associated with periapical pathology. The aim of this systematic review was to find the diagnostic accuracy of CBCT for detection of the second canal of the root canal system of permanent teeth. Materials and Methods. The articles were selected from seven electronic databases according to selection criteria. All eligible studies were judged by the reviewers. The selected studies were checked with the QUADAS-2 tool for risk of bias and applicability concerns. Finally, 12 studies were selected for qualitative and quantitative analyses. The summary estimates of sensitivities and specificities and SROC curves were calculated and drawn by RevMan 5.3 and MetaDTA software. Results. Summary estimates of CBCT for detection of second canal anatomy in permanent teeth were 94% sensitivity and 93.1% specificity. 96.6% sensitivity of MB2 was followed by 88.8% sensitivity of maxillary and mandibular premolars and 81% that of mandibular molars. The specificity of 97.6% for premolars was trialed by 85% specificity of mandibular molars and MB2. For permanent mandibular canines, 67% sensitivity and 100% specificity were estimated. CBCT showed more agreement with detecting the second canal with micro-CT, estimating 100% sensitivity and 95.6% specificity. The highest prevalence of the second canal comprised the highest sensitivity of 99.1% and lowest specificity of 77.5%. After the exclusion of case-control studies, a 3% drop of sensitivity from the summary estimate was observed. Multiple spectrum of the second canal had 8.6% higher sensitivity and 4.4% lower specificity than single spectrum. Conclusion. CBCT is informative for detecting the second canal. Clinicians should keep in mind that the accuracy can vary in different types of teeth, with the prevalence of second canal across different populations, and with the spectrum of second canal anatomy in spite of the reviewers having postulated overestimation of the findings.

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Tests to detect and inform the diagnosis of root caries

Abstract: Tests to detect and inform the diagnosis of root caries.

Cited by 9 publications

References 98 publications

Development of a Root Caries Prediction Model in a Population of Dental Attenders

Development of a Root Caries Prediction Model in a Population of Dental Attenders

Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions

Diagnostic Accuracy of CBCT for Detection of Second Canal of Permanent Teeth: A Systematic Review and Meta-Analysis

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