Dental enamel defect diagnosis through different technology-based devices

Abstract

Introduction: Dental enamel defects (DEDs) are faulty or deficient enamel formations of primary and permanent teeth. Changes during tooth development result in hypoplasia (a quantitative defect) and/or hypomineralisation (a qualitative defect).

Objective: To compare technology-based diagnostic methods for detecting DEDs.

Material and methods: Two-hundred and nine dental surfaces of anterior permanent teeth were selected in patients, 6-11 years of age, with cleft lip with/without cleft palate. First, a conventional clinical examination was conducted according to the modified Developmental Defects of Enamel Index (DDE Index). Dental surfaces were evaluated using an operating microscope and a fluorescence-based device. Interexaminer reproducibility was determined using the kappa test. To compare groups, McNemar's test was used. Cramer's V test was used for comparing the distribution of index codes obtained after classification of all dental surfaces.

Results: Cramer's V test revealed statistically significant differences (P < .0001) in the distribution of index codes obtained using the different methods; the coefficients were 0.365 for conventional clinical examination versus fluorescence, 0.961 for conventional clinical examination versus operating microscope and 0.358 for operating microscope versus fluorescence. The sensitivity of the operating microscope and fluorescence method was statistically significant (P = .008 and P < .0001, respectively). Otherwise, the results did not show statistically significant differences in accuracy and specificity for either the operating microscope or the fluorescence methods.

Conclusion: This study suggests that the operating microscope performed better than the fluorescence-based device and could be an auxiliary method for the detection of DEDs.

Keywords: Tooth enamel; dental operating microscope; diagnosis; fluorescence.

Figure 1.

Representative images with codes 0–3 of the modified Developmental Defects of Enamel Index (DDE Index)¹ for operating microscope (OM) and fluorescence-based methods. Code 0: OM (a) and fluorescence-based (b) methods; code 1, OM (c) and fluorescence-based (d) methods; code 2, OM (e) and fluorescence-based (f) methods; and code 3, OM (g) and fluorescence-based (h) methods.

Figure 2.

Representative images with codes 5–8 of the modified Developmental Defects of Enamel Index (DDE Index)¹ for OM and fluorescence-based methods. Code 5, OM (a) and fluorescence-based (b) methods; code 6, OM (c) and fluorescence-based (d) methods; code 7, OM (e) and fluorescence-based (f) methods; and code 8, OM (g) and fluorescence-based (h) methods.