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3. Cariogenic Diet Assessment and Analysis Tools in Children and Adolescents: A Systematic Review.

Author

Angelopoulou, Matina V., Seremidi, Kyriaki, Benetou, Vasiliki, Agouropoulos, Andreas, Rahiotis, Christos, and Gizani, Sotiria

Subjects
DIET, FOOD diaries, TEENAGERS, FOOD habits, DATA extraction
Abstract

Purpose: To collect and evaluate the available evidence on existing tools used in research and clinical practice to assess and analyse the diet of children and adolescents for its cariogenicity. Materials and Methods: Multiple databases were searched up to October 2022, with no date, publication, or language restrictions, followed by a manual search. Study screening, data extraction, and risk of bias assessment were performed in duplicate. Dietary assessment tools and dental clinical parameters tested were retrieved for qualitative assessment and synthesis. Results: Of the 2896 papers identified, 9 cohort and 23 cross-sectional studies fulfilled the inclusion criteria. To assess dietary data, 13 studies used a 24-h recall, 11 used a food diary, and 7 used a food frequency questionnaire. For analysis, five studies reported using the Healthy Eating Index, ten used a score based on consumption of sugars, and the remaining analysed cariogenic diet based on the weight and frequency of sugars consumed, or the daily caloric intake from free sugars. Risk of bias assessment suggested that 65.7% of the studies were of moderate and 31.5% of high quality. Conclusion: Inconsistency exists regarding methods used for the assessment and analysis of dietary cariogenicity. Although every dietary assessment tool has different strengths and limitations, the 24-h recall was the most commonly used method for the assessment of dietary cariogenicity and the most consistent in detecting a positive relationship between sugary diet and carious lesions. A standardised method for cariogenic analysis of dietary data needs to be determined. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Different Methods of Scan Alignment in Erosive Tooth Wear Measurements:An In Vitro Study

Author

Loumprinis, Nikolaos, Michou, Stavroula, Rahiotis, Christos, Loumprinis, Nikolaos, Michou, Stavroula, and Rahiotis, Christos

Abstract

BACKGROUND: Model alignment in cases of erosive tooth wear can be challenging, and no method has been reported to outweigh the others.METHODS: Extracted human teeth were mounted on two models and scanned at different times, from 1 h to 2 weeks, with an intraoral scanner (3Shape TRIOS 4) before and after immersion in Monster® energy drink and tap water. The scans were superimposed (3Shape TRIOS Patient Monitoring, Version 2.2.3.3, 3Shape A/S, Copengagen, Denmark). Best fit, best-fit tooth comparison, reference best fit using fillings, and palatal rugae as reference points were used for alignment. Surface profile differences were calculated in a cross-section view. The nonparametric Bland-Altman and Kruskal-Wallis tests were used.RESULTS: First, statistically significant differences were marked after 4 days of immersion. The measurements obtained after 2 weeks of immersion were statistically significantly different from the measurements obtained at the different time points until 1 week. No statistically significant differences (p < 0.05) were observed among the alignment methods at any time.CONCLUSION: In comparison to the best-fit model, both palatal rugae and fillings can be used. The best-fit tooth comparison method is a reliable option; however, it should be used with caution in cases of major surface loss.

Published
2024

11. A 2-Year Randomized Clinical Trial of Three Bonding Techniques in Non-Carious Cervical Lesions.

Author

Pappa, Eftychia, Gkavela, Grigoria, Sampri, Ioanna, Masouras, Konstantinos, Rahiotis, Christos, and Kakaboura, Afrodite

Subjects
DENTAL acid etching, DENTAL bonding, COHEN'S kappa coefficient (Statistics), ADHESIVES, GENERALIZED estimating equations, CLINICAL trials, LOGISTIC regression analysis
Abstract

Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram/Ivoclar/Vivadent), bonded with a total-etch adhesive agent (ExciTE F/Ivoclar/Vivadent) and a self-etch (AdheSE One F/Ivoclar/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen's kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years. [ABSTRACT FROM AUTHOR]

Published
2024
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16. A suggested universal protocol for dental examination in sports.

Author

Stamos, Athanasios, Engels‐Deutsch, Marc, Cantamessa, Sophie, Dartevelle, Jean‐Luc, Crouzette, Thierry, Haughey, John, Grosso, Flavia Del, Avgerinos, Stavros, Fritsch, Tilman, Nanussi, Alessandro, Trombowsky, Florian, Striegel, Markus, Salyzyn, Mike, Whitehead, Jim, Stasiuk, Hans, Canal, Emilio, Amy, Enrique, Roettger, Mark, and Rahiotis, Christos

Subjects
ATHLETES' health, SPORTS physicians, STOMATOGNATHIC system, PRACTICE (Sports), PROFESSIONAL sports, DENTAL students
Abstract

The athletes of any sport and level submit their bodies to constant exercise. Any given pathology can increase the risk of injury, illness, or even reduced performance. The medical examination is valuable in diagnosing existing health problems and preventing medical issues that might compromise the athlete's overall health when exercising. The stomatognathic system is not an exemption, as oral pathologies, including dental caries and periodontal diseases, are found in high incidence in sports. The need for accurate and detailed dental examination in sports leaded dentists from the European Association for Sports Dentistry and the Academy for Sports Dentistry to elaborate a universal dental examination in sports protocol that can record the overall oral health of the athlete, including the teeth, periodontium, and musculoskeletal screening, for all athletes. The outcome of this stomatognathic examination allows sports physicians and professionals other than dentists to have a complete image of the individual oral health condition of any given athlete, and it allows the dentists to efficiently screen and prevent pathologies, as well as to advise on the eligibility to practice sports from the oral health perspective. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Fluorescence and Near-Infrared Light for Detection of Secondary Caries:A Systematic Review

Author

Spagopoulos, Dimitrios, Michou, Stavroula, Gizani, Sotiria, Pappa, Eftychia, Rahiotis, Christos, Spagopoulos, Dimitrios, Michou, Stavroula, Gizani, Sotiria, Pappa, Eftychia, and Rahiotis, Christos

Abstract

Background: Early detection of secondary caries near dental restorations is essential to prevent further complications. This systematic review seeks to evaluate the sensitivity of fluorescence and near-infrared (NIR) imaging techniques for detecting secondary caries and to provide insight into their clinical utility. Methods: A comprehensive search strategy was used to select studies from seven databases, emphasizing diagnostic accuracy studies of secondary caries detection using fluorescence and NIR imaging techniques. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) instrument assessed bias risk and practicality. Two evaluators performed data extraction, screening, and quality assessment independently. Results: From 3110 initial recordings, nine studies were selected for full-text analysis. Wide variations in sensitivity (SE) and specificity (SP) values were reported across the studies. These studies exhibited variable SE and SP values, and the findings highlighted the importance of method selection based on clinical context. This systematic review underlines the potential for fluorescence and NIR imaging to detect secondary caries. However, results from different studies vary, indicating the need to consider additional variables such as restoration materials. Conclusions: Although these technologies exhibit potential for detecting caries, our research underscores the complex procedure of identifying secondary caries lesions. It is a continuous necessity for progress in dental diagnostics to promptly identify secondary caries lesions, particularly those in proximity to tooth-colored ones.

Published
2023

23. List of contributors

Author

Eliades, Theodore, primary, Brantley, William, additional, Berzins, David, additional, Bourauel, Christoph, additional, Bradley, T. Gerard, additional, Cai, Zhuo, additional, Iijima, Masahiro, additional, Kim, Do-Gyoon, additional, Kloukos, Dimitrios, additional, Pandis, Nikolaos, additional, Papageorgiou, Spyridon, additional, Patcas, Raphael, additional, Rahiotis, Christos, additional, Schricker, Scott, additional, Sifakakis, Iosif, additional, Tufekci, Eser, additional, and Zinelis, Spiros, additional

Published
2017
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32. Κρανιογναθικό σύστημα

Author

Rahiotis, Christos and Tosios, Konstantinos

Subjects
Περιοδοντικοί ιστοί, Σάλιο, Tooth development, Οδοντίνη, Tooth structure, Οστό, Στοματικός Βλεννογόνος, Enamel, Διάπλαση δοντιού, Dentin, Διάπλαση προσώπου, Oral mucosa, Facial Development, Αδαμαντίνη, Saliva, Periodontical tissues, Bone, Δομή δοντιού
Abstract

The content of the book includes embryology, structure, and development of the craniomaxillofacial complex, anatomy, histology, and physiology of the structures of the craniomaxillofacial complex, and in particular, the tooth, periodontal tissues, oral mucosa, and salivary glands, as well as the ecology and normal microbial flora of the mouth. The content of the book comes to a large extent to "cover" the teaching content of the courses of the undergraduate study program "Craniostomatognathic system I" and "Craniostomatognathic system II", which are taught in the 2nd and 3rd semesters of the undergraduate program of the School of Dentistry of National and Kapodistrian University of Athens. In the 1st chapter, the development and formation of the craniofacial complex are presented. In the 2nd chapter, the embryology, anatomy, histology, structure, and properties of the hard dental tissues of the molar and tooth root, i.e. enamel, dentin, and cementum, are described. In the 3rd chapter, the anatomy of the periodontal tissues is described, i.e. the free and attached gums, the interdental papillae, the jaw bone, and the gingival fissure. In the 4th chapter, the oral mucosa is described, depending on the functional specialization. Finally, in the 5th chapter, the concept of "biofilm" and the basic principles of biofilm formation is developed., Το περιεχόμενο του βιβλίου περιλαμβάνει την εμβρυολογία, τη διάπλαση και ανάπτυξη του κρανιοστοματογναθικόυ συμπλέγματος, την ανατομία, την ιστολογία και τη φυσιολογία των δομών του κρανιοστοματογναθικού συμπλέγματος, και ειδικότερα του δοντιού, των περιοδοντικών ιστών, του στοματικού βλεννογόνου, και των σιελογόνων αδένων, καθώς και την οικολογία και τη φυσιολογική μικροβιακή χλωρίδα του στόματος. Το περιεχόμενο του βιβλίου έρχεται σε μεγάλο βαθμό να «καλύψει» το διδακτικό περιεχόμενο των μαθημάτων του προπτυχιακού προγράμματος σπουδών «Κρανιστοματογναθικό σύστημα Ι» και «Κρανιστοματογναθικό σύστημα ΙΙ», τα οποία διδάσκονται στο 2ο και 3ο εξάμηνο σπουδών του προπτυχιακού προγράμματος της Οδοντιατρικής Σχολής του ΕΚΠΑ. Στο 1ο κεφάλαιο παρουσιάζεται η εξέλιξη και διάπλαση του κρανιοπροσωπικού συμπλέγματος (ΚΠΣ). Στο 2ο κεφάλαιο περιγράφεται η εμβρυολογία, η ανατομία, η ιστολογία, η δομή και οι ιδιότητες των σκληρών οδοντικών ιστών της μύλης και της ρίζας του δοντιού, δηλαδή της αδαμαντίνης, οδοντίνης και οστεΐνης. Στο 3ο κεφάλαιο περιγράφεται η ανατομία των περιοδοντικών ιστών, δηλαδή των ελεύθερων και προσπεφυκότων ούλων, των μεσοδόντιων θηλών, του περιρριζίου, του οστού των γνάθων, και της ουλοδοντική σχισμή. Στο 4ο κεφάλαιο περιγράφεται ο στοματικός βλεννογόνος, ανάλογα με τη λειτουργική εξειδίκευση. Τέλος, στο 5ο κεφάλαιο αναπτύσσεται η έννοια «βιοϋμένιο» και οι βασικές αρχές σχηματισμού των βιοϋμενίων.

Published
2022
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42. Automated caries detection in vivo using a 3D intraoral scanner:[incl. Publisher Correction]

Author

Michou, Stavroula, Lambach, Mathias S., Ntovas, Panagiotis, Benetti, Ana R., Bakhshandeh, Azam, Rahiotis, Christos, Ekstrand, Kim R., and Vannahme, Christoph

Abstract

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 ([Formula: see text]). 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, ([Formula: see text]). 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.

Published
2021

43. Downregulation of Salivary Proteins, Protective against Dental Caries, in Type 1 Diabetes

Author

Pappa, Eftychia Vougas, Konstantinos Zoidakis, Jerome and Papaioannou, William Rahiotis, Christos Vastardis, Heleni

Abstract

Saliva, an essential oral secretion involved in protecting the oral cavity's hard and soft tissues, is readily available and straightforward to collect. Recent studies have analyzed the salivary proteome in children and adolescents with extensive carious lesions to identify diagnostic and prognostic biomarkers. The current study aimed to investigate saliva's diagnostic ability through proteomics to detect the potential differential expression of proteins specific for the occurrence of carious lesions. For this study, we performed bioinformatics and functional analysis of proteomic datasets, previously examined by our group, from samples of adolescents with regulated and unregulated type 1 diabetes, as they compare with healthy controls. Among the differentially expressed proteins relevant to caries pathology, alpha-amylase 2B, beta-defensin 4A, BPI fold containing family B member 2, protein S100-A7, mucin 5B, statherin, salivary proline-rich protein 2, and interleukin 36 gamma were significantly downregulated in poorly-controlled patients compared to healthy subjects. In addition, significant biological pathways (defense response to the bacterium, beta-defensin activity, proline-rich protein activity, oxygen binding, calcium binding, and glycosylation) were deregulated in this comparison, highlighting specific molecular characteristics in the cariogenic process. This analysis contributes to a better understanding of the mechanisms involved in caries vulnerability in adolescents with unregulated diabetes.

Published
2021

44. Automated caries detection in vivo using a 3D intraoral scanner

Author

Michou, Stavroula Lambach, Mathias S. Ntovas, Panagiotis and Benetti, Ana R. Bakhshandeh, Azam Rahiotis, Christos and Ekstrand, Kim R. Vannahme, Christoph

Abstract

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 105 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). 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). 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.

Published
2021

45. Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis

Author

Foros, Petros; https://orcid.org/0000-0002-6814-9210, Oikonomou, Elissaios, Koletsi, Despina; https://orcid.org/0000-0001-6280-9372, Rahiotis, Christos, Foros, Petros; https://orcid.org/0000-0002-6814-9210, Oikonomou, Elissaios, Koletsi, Despina; https://orcid.org/0000-0001-6280-9372, and Rahiotis, Christos

Abstract

The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included “early caries” and “caries detection.” Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81–0.89, followed by ICDAS-II at 0.62–1, DIAGNOdent (DD) at 0.48–1, and bitewing radiography (BW) at 0–0.29. The corresponding specificity (Sp) range was: DD Pen 0.71–0.8, ICDAS-II 0.5–0.84, DD 0.54–1, and BW 0.96–1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7–0.96 and DD Pen 0.55–0.90, followed by ICDAS-II 0.25–0.93, and BW 0–0.83. The Sp range was: DD 0.54–1, DD Pen 0.71–1, ICDAS-II 0.44–1, and BW 0.6–1. For approximal surfaces, the Se was: BW 0.75–0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6–0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55–1, DD Pen 0.63–1, ICDAS-II 0.42–1, and BW 0.31–0.96; the respective Sp was: DD 0.5–1, DD Pen 0.44–1, ICDAS-II 0.61–1, and BW 0.79–0.98. For approximal surfaces, the Se range was: DD Pen 0.58–0.63, ICDAS-II 0.42–0.55, and BW 0.14–0.71. The corresponding Sp range was: DD Pen 0.85–0.87, ICDAS-II 0.73–0.93, and BW 0.79–0.98. Se and Sp values varied

Published
2021

48. Internists' and Endocrinologists' Knowledge and Attitudes Regarding Periodontal Disease, Caries, Xerostomia and Diabetes Mellitus: A National Survey.

Author

Rahiotis, Christos, Petsiou, Eleni, and Mitrou, Panagiota

Subjects
ENDOCRINOLOGISTS, PERIODONTAL disease, XEROSTOMIA, DENTAL education, EDUCATIONAL programs
Abstract

Objectives: The present study aims to investigate the current knowledge, attitudes and behaviors of clinicians dealing with diabetes regarding the relationship of Diabetes Mellitus (DM) and odostomatological diseases, such as periodontal disease, xerostomia and caries. Methods: A twenty-four item closed-ended multiple-choice questionnaire was completed by 225 Greek medical doctors. The sample was divided into three groups according to specialty: a) Endocrinologists; b) Internists; c) Internal medicine registrars. Bivarate analysis, Fisher test, and Spearman correlation were used for statistical analysis. Results: Most doctors were aware of the bidirectional relationship between periodontal disease and DM. Regarding the relationship between DM and xerostomia, 50% of doctors were unaware that patients with DM have an increased risk of xerostomia and were unfamiliar with the relevant studies. Nearly 50% of doctors agreed that patients with diabetes are at increased risk of developing caries. Age, specialty, and years of expertise had an impact on the way of doctors' answer. Finally, 78.6% of doctors treating diabetes considered that they should cooperate with dentists to reduce their patients' risk of odontostomatological complications. Conclusion: The relationship between diabetes and dental problems is often underestimated. Implementation of medical and dental educational programs oriented in increasing inter-professional education as well as collaboration between dentists and doctors dealing with diabetes, are needed in order to achieve the goal of better care of patients with diabetes. [ABSTRACT FROM AUTHOR]

Published
2022

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