Detecting and monitoring dental plaque is an important issue in research and clinical practice. In this context, new digital imaging methods that permit permanent documentation of the clinical findings could be promising tools. The aim of the study was therefore to investigate whether disclosed plaque can be reliably visualised on 2D and 3D images captured with digital intraoral imaging devices. Clinical examination was the reference method. Twenty subjects (27.5±1.2 years) were included and plaque was measured at three different stages: habitual plaque (T1), after 72 h without oral hygiene (T2) and after a subsequent habitual brushing exercise (T3). At each time point, plaque was disclosed followed by the clinical examination and capturing the 2D and 3D images (intraoral-camera CS 1500 and intraoral-scanner CS 3600; Carestream Dental, Germany). Plaque amounts were recorded on oral and vestibular surfaces of the Ramfjord-teeth (16, 21, 24, 36, 41, 44) using the Rustogi-modified-Navy-Plaque-Index (RMNPI) and expressed as percentage of plaque-containing RMNPI areas of all RMNPI areas. At T1, percentages (mean±SD) obtained from the clinical examination, 2D and 3D images were 62.2±10.6, 65.1±10.0 and 64.4±10.6 resp. increasing to 76.9±8.0, 77.9±8.6 and 77.5±9.4 resp. at T2. After toothbrushing (T3), values decreased to 56.3±11.1, 58.2±12.1 and 61.2±10.8 resp. All methods were able to show statistically significant changes in plaque amounts at the different time points with in part statistically significant but minor differences between them. The Bland-Altmann analysis revealed a good agreement between values from both 2D and 3D images with the clinical examination. The agreement of the scores obtained with the both image-based methods for the single RMNPI areas with the clinical examination was mainly classified as substantial to almost perfect. Amounts of plaque can be reliably detected and monitored on 2D images from an intraoral camera and on 3D images from an intraoral scanner.
Planimetry is a reliable method for detecting and monitoring plaque. Until now, this method has mainly been applied to conventional-camera images, which is difficult and time-consuming in relation to the entire dentition. Today, 3D-intraoral-scans are well suited for imaging the entire dentition and are therefore an efficient and feasible alternative. 3D-intraoral-scans have already proven successful for the quantification of plaque based on a plaque index. Therefore, aim of this study was to investigate whether images from 3D-intraoral-scans are also suitable for valid planimetric plaque measurements and monitoring; intraoral-camera images served as a reference. Twenty subjects (27.5±1.2 years) were included. Plaque was disclosed at three different time points: habitual plaque (T1), after 72 h without oral hygiene (T2) and after subsequent tooth brushing (T3) and quantified using 3D-intraoral-scans and intraoral-camera images (intraoral-camera CS 1500, intraoral-scanner CS 3600; Carestream Dental, Germany). The percentage of the plaque-covered surface of the total surface area (P%) was determined with a software specially programmed for this purpose using images from 3D-intraoral-scans of the oral and vestibular surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, and 44); the intraoral-camera images of the vestibular surfaces of 16 and 36 served as reference. P% from images of the 3D-intraoral-scan and the intraoral-camera revealed a very good correlation (r = 0.876; p ≤ 0.001); the Bland-Altmann analysis showed a good agreement with no proportional and a very minor systematic bias with slightly higher values from images of the 3D-intraoral-scan. Further, P% measurements of the images of the 3D-intraoral-scan were able to detect changes in plaque levels, showing a 47% (p ≤ 0.001) increase in P% from T1 to T2 and a 43% (p ≤ 0.001) decrease after toothbrushing (T3). Planimetry using images of the 3D-intraoral-scan seems to be a suitable tool for whole mouth planimetry to record and monitor dental plaque.
The aim of this study was to evaluate the clinical long-term performance of a visible light-cured resin (VLCR) denture base material and to compare it to a well-established polymethylmethacrylate (PMMA)-based denture acrylic in a randomized split-mouth clinical long-term study. One hundred removable partial dentures in 90 patients, with at least two saddles each, were investigated. One saddle was made of VLCR, while the other was made of PMMA at random. Plaque adhesion, tissue reaction, and technical parameters of the dentures were assessed 6, 12, and 18 months after treatment. Statistical analysis was performed using the Wilcoxon rank-sum test. Though VLCR showed higher plaque adhesion than PMMA after 6, 12, and 18 months (p < 0.001), there were no important differences with regard to tissue reaction. Concerning plaque adhesion, surface quality with regard to the lower side, interfaces between denture acrylic and metal and the boundary between denture acrylic and denture tooth PMMA was rated higher than VLCR. The surface quality of the upper side of the denture saddles showed no significant differences (p > 0.05). Neither VLCR nor PMMA showed discoloration at any point in time (p > 0.05). It can be concluded that VLCR is a viable alternative for the production of removable dentures. Especially in patients with hypersensitivities to PMMA, VLCR is particularly suitable for clinical use.
Video observation (VO) is an established tool for observing toothbrushing behaviour, however, it is a subjective method requiring thorough calibration and training, and the toothbrush position is not always clearly visible. As automated tracking of motions may overcome these disadvantages, the study aimed to compare observational data of habitual toothbrushing as well as of post-instruction toothbrushing obtained from motion tracking (MT) to observational data obtained from VO. One-hundred-three subjects (37.4±14.7 years) were included and brushed their teeth with a manual (MB; n = 51) or a powered toothbrush (PB; n = 52) while being simultaneously video-filmed and tracked. Forty-six subjects were then instructed how to brush their teeth systematically and were filmed/tracked for a second time. Videos were analysed with INTERACT (Mangold, Germany); parameters of interest were toothbrush position, brushing time, changes between areas (events) and the Toothbrushing Systematic Index (TSI). Overall, the median proportion (min; max) of identically classified toothbrush positions (both sextant/surface correct) in a brushing session was 87.8% (50.0; 96.9), which was slightly higher for MB compared to PB (90.3 (50.0; 96.9) vs 86.5 (63.7; 96.5) resp.; p = 0.005). The number of events obtained from MT was higher than from VO (p < 0.001) with a moderate to high correlation between them (MB: ρ = 0.52, p < 0.001; PB: ρ = 0.87; p < 0.001). After instruction, both methods revealed a significant increase of the TSI regardless of the toothbrush type (p < 0.001 each). Motion tracking is a suitable tool for observing toothbrushing behaviour, is able to measure improvements after instruction, and can be used with both manual and powered toothbrushes.
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