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Photograph of teeth prior to disclosure with plaque finder, b) Photograph of teeth following plaque disclosure, and c, d and e) examples of QLF images of disclosed dental plaque
Source publication
To determine the effects of a detergent-free, whitening dentifrice using an in vivo plaque regrowth model with the novel application of QLF as a planimetric analysis tool.
A total of 20 subjects took part in a double blind, single-centre, crossover study in which slurry rinses were the only form of plaque control over a 5-day period. Following a wa...
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To evaluate and compare the effectiveness in reducing plaque of a fluoride dentifrice containing baking soda and a non-baking soda fluoride dentifrice containing an antimicrobial (triclosan/copolymer) system after a single brushing and over a four-week period of daily brushing.
A total of 207 subjects completed this randomized, blinded, parallel-gr...
To compare the removal of dental biofilm with soft and medium filament toothbrushes.
Twenty-five patients refrained from performing mechanical or chemical plaque control for 96 hours prior to the experiment in order to allow dental biofilm accumulation on the tooth surfaces. After the period of dental biofilm accumulation, quadrants were randomised...
Citations
... Plaque thickness quantification using CMM [72] Indices that measure plaque using QLF™ Plaque detection with Quantitative Light Fluorescence (QLF) [19] Autofluorescence-based Plaque Quantification (APQ) [66] Simple Plaque Score (SPS) o QLF-D score [67] QLF-D ∆R score [67] Fluorescent Plaque Index (FPI) [68] Percentage Plaque Index (PPI) using QLF planimetric analysis [75] ...
Dental plaque is a biofilm structured in an extracellular matrix of polymers of host and microbial origin; the microorganisms can coexist in harmony with the host, thus guarantying oral health. Environmental modifications can lead to dysbiosis and onset of oral diseases; in fact, plaque is the etiological agent both of periodontal disease and dental decay. The use of an effective oral hygiene index should be considered as a relevant goal for the clinicians and the researchers, and consequently, numerous plaque indices have been proposed during the years. The present literature review aims primarily to obtain a complete summary of these scores to assess plaque deposits. It is useful because the clinician/researcher will select the right scoring method for the specific situation only if he knows the available options and if he is aware of both their strengths and weaknesses. This review applies a basic classification of plaque indices that distinguishes the ones that use non-quantitative methods from the ones that use quantitative methods. Non-quantitative methods are more subjective because they are based on the ability of the clinician to point out the presence or the entity of deposits, while quantitative methods introduce objectifiable means to measure plaque deposits.
... Fluorescence images enhance the contrast between soft tissues (nonfluorescent), teeth (green autofluorescent), and the red disclosed plaque (Pretty et al., 2004(Pretty et al., , 2005Han et al., 2016), and thereby provide a better basis for semi-automated image segmentation. ...
Aim:
This study developed a simple, reproducible method for semiautomated planimetric quantification of dental plaque.
Materials and methods:
Plaque from 20 healthy volunteers was disclosed using erythrosine, and fluorescence images of the first incisors, first premolars and first molars were recorded after 1, 7 and 14 days of de novo plaque formation. The planimetric plaque index (PPI) was determined using a semi-automated threshold-based image segmentation algorithm and compared to manually determined PPI and the Turesky modification of the Quigley-Hein plaque index (TM-QHPI). The decrease of tooth autofluorescence in plaque-covered areas was quantified as an index of plaque thickness (TI). Data were analyzed by ANOVA and Pearson correlations.
Results:
The high contrast between teeth, disclosed plaque, and soft tissues in fluorescence images allowed for a fast threshold-based image segmentation. Semi-automated PPI strongly correlated with manual planimetry (r=0.92; P<.001) and TM-QHPI recordings (r=0.88; P<.001), and it may exhibit a higher discriminatory power than TM-QHPI due to its continuous scale. TI values corresponded to optically perceived plaque thickness, and no differences were observed over time (P>0.05, ANOVA).
Conclusion:
The proposed semi-automated planimetric analysis based on fluorescence images is a simple and efficient method for dental plaque quantification in multiple images with reduced human input. This article is protected by copyright. All rights reserved.
... Mucosal diseases present challenges in oral hygiene and plaque control in regions with ulceration due to discomfort caused not only by physical brushing but also potentially by toothpaste constituents. It has been suggested that conventional formulations containing certain detergents may act to exacerbate some ulcerative conditions intraorally [91][92][93][94][95]. Unfortunately, chemical methods of plaque are often also not helpful. ...
... Even if diluted to the lowest effective concentration, many patients still report significant pain. Consequently, many patients will resort to using non-foaming, detergent-free agents and softer brushes, although removal of detergent may not impair plaque control [94,95]. ...
Periodontal and chronic oral mucosal diseases are significant life impacting conditions which may co-exist and synergistically act to cause more severe and widespread oral pathology with enhanced challenges in effective management. Clinicians regularly observe these effects and struggle to effectively manage both problems in many patients. There is limited understanding of many basic and applied scientific elements underpinning potentially shared aetiopathological features and management. Recent developments in translational science provide an opportunity to greater improve knowledge and subsequently care for patients with these problems.
... Among the studies, products that contained xylitol as a sweetener or as a secondary compound were also observed, as in probiotic formulations [74]. Furthermore, other products, also related to dentistry, showed a combination of xylitol and sorbitol or fluoride to control dental biofilm, white spot lesions and improve salivary parameters [23,30,[75][76][77][78][79][80][81]. However, there was no statistical difference between studies regarding the effect of products with isolated xylitol compared to xylitol associated with other active compounds in the present review. ...
Objective
To describe and evaluate the xylitol products’ applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans.
Material and Methods
Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects.
Results
From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03).
Conclusion
Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.
Keywords:
Xylitol; Therapeutics; Randomized Controlled Trials as Topic; Bibliometrics
... Various indices have been used to quantify dental biofilm in different clinical and research settings. Though these indices quantify biofilm in an objective manner, they are not devoid of certain limitations such as subjective assessment of the operator [12][13][14]. Several authors have proposed other methods such as the use of grids and planimetric systems including the use of fluorescent light to visualize and measure biofilm [12,15]. ...
AIM:To compare the effects of a plaque disclosing toothpaste with a regular fluoridated toothpaste for supragingival biofilm reduction in patients with chronic gingivitis.
MATERIALS AND METHODS:This study was a randomized controlled trial with a parallel design. Forty patients, both males and females aged 18-25 years with chronic generalized gingivitis (N=40) were randomly allocated to two groups of twenty each (n=20), using lottery method. Participants in the experimental group brushed with a plaque disclosing toothpaste, while participants in the control group brushed with regular fluoridated toothpaste. Clinically, biofilm was measured using Silness & Loe Plaque Index, both at baseline and at follow up visits by two assessors who were blinded to group allocation. Adjunctly, intraoral photographs were taken for Digital Plaque Image Analysis of the remaining dental biofilm in the upper and lower anterior labial tooth surfaces, and calculated based on the area of stained pixels. Data was analyzed using SPSS version 22. Mean plaque scores between the groups were compared using independent sample t-test and p
... 2,12 Planimetric analysis has already been described and used to assess cleaning efficacy in several studies. 3,5,9,13,15,18,19 The fact that samples were stained using a pH-4 black tea for 17 h leads to the logical assumption that they were simultaneously eroded. This duration is exaggerated and does not correspond to the quotidian situation in which teeth are in contact with staining agents for much less time. ...
PURPOSE To investigate dentin abrasivity and cleaning efficacy of novel/alternative toothpastes containing diamond particles, active carbon, sea salt or organic oils. MATERIALS AND METHODS Seventy-two bovine dentin samples (for measuring abrasivity) and 60 human dentin samples (for assessing cleaning efficacy) were used in this study. Samples were divided into six groups as follows: group 1: Elmex Kariesschutz (hydrated silica); group 2: Lavera Neutral Zahngel (sea salt); group 3: Curaprox Black is White (active carbon); group 4: Swiss Smile Diamond Glow (diamond powder); group 5: Ringana Fresh Tooth Oil (hydrated silica); and group 6: artificial saliva. Samples were brushed for a total of 26 min at 120 strokes/min, replacing slurries (1 part respective toothpaste and 2 parts artificial saliva) every 2 min. Finally, abrasive dentin wear was measured profilometrically and cleaning efficacy planimetrically. RESULTS The highest abrasivity values were observed for Lavera Neutral Zahngel (sea salt 9.2 µm) and Elmex Kariesschutz group (hydrated silica 6.0 µm). The lowest abrasivity value was observed for Ringana Fresh Tooth Oil group (hydrated silica 1.3 µm). The highest cleaning efficacy was observed for Elmex Kariesschutz group (86.7%) and the lowest cleaning efficacy was observed for Ringana Fresh Tooth Oil group (31.3%). CONCLUSION The addition of diamond powder or active carbon to toothpastes could offer high cleaning efficacy with low dentin abrasivity. The addition of sea salt to traditional abrasives might cause high abrasive dentin wear without adding further cleaning benefit.
... Also possible were semi-automatic approaches, whereby the image-processing algorithm required intervention from the dental expert to work [16,17], or images could be segmented automatically using image-processing techniques [18][19][20]. Some researchers used image-processing software [16,17,[21][22][23] or general-purpose data-processing tools [24,25], while others developed their own methods to process these images [24,26]. More recently, specific dental-assessment software has been used to quantify plaque levels [18,27]. ...
... One of the simplest methods was image thresholding, which made it possible to isolate two or more different areas according to their color or light intensities. This technique was able to distinguish between: disclosed plaque and non-plaque [24,28]; teeth, plaque, and gingiva pixels [23]; and isolated teeth, gums, plaque and background areas [29,30]. More sophisticated machine-learning algorithms were subsequently developed to enhance the results. ...
... It is well known the importance that dental plaque has in the etiopathogenesis of important oral diseases, such as caries and periodontitis [5,44]; and on the other hand, the recognized limitations of conventional clinical indices of dental plaque quantification [20,23] which are widely used both in clinical and research settings. Therefore, in order to improve the diagnosis of dental plaque, it is essential to develop new computer systems that allow the objective quantification of dental plaque levels. ...
BACKGROUND
In the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the two most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers.
OBJECTIVE
To develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques.
METHODS
The tool is executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization), at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as non-visible plaque. This new term implies the classification of the remaining dental area into three subregions, according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and non-visible plaque levels.
RESULTS
The system generates results tables on the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and non-visible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: the plaque index of an area per intensity (API index, a value between 0-100); the area growth index (growth rate of plaque per unit of time in hours - percentage area/hour); and the area time index (the time, in days, needed to achieve a plaque area of 100% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient and in addition to a full report presenting all the processing data. Dentistry experts evaluated the DenTiUS Plaque software through a usability test, giving the best-scoring questions those related to the workflow efficiency, the value of the online help, the attractiveness of the user interface, and the overall satisfaction.
CONCLUSIONS
The DenTiUS software allows an automatic, reliable and repeatable quantification of dental plaque levels, providing information about area, intensity and growth pattern. Dentistry experts recognized that DenTiUS Plaque software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies.
... Some researchers used image-processing software [16,17,[21][22][23] or general-purpose data-processing tools [24,25], while others developed their own methods to process these images [24,26]. More recently, specific dental assessment software has been used to quantify plaque levels [18,27]. ...
... One of the simplest methods was image thresholding, which made it possible to isolate two or more different areas according to their color or light intensities. This technique was able to distinguish between disclosed plaque and nonplaque [24,28]; teeth, plaque, and gingiva pixels [23]; and isolated teeth, gums, plaque, and background areas [29,30]. More sophisticated machine learning algorithms were subsequently developed to enhance the results. ...
... The importance of dental plaque in the etiopathogenesis of important oral diseases, such as caries and periodontitis, is well-known [5,46]; on the other hand, there are recognized limitations of conventional clinical indices of dental plaque quantification [20,23], which are widely used both in clinical and research settings. Therefore, to improve the diagnosis of dental plaque, it is essential to develop new computer systems that allow the objective quantification of dental plaque levels. ...
Background:
In the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the two most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers.
Objective:
To develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques.
Methods:
The tool is executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization), at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as non-visible plaque. This new term implies the classification of the remaining dental area into three subregions, according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and non-visible plaque levels.
Results:
The system generates results tables on the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and non-visible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: the plaque index of an area per intensity (API index, a value between 0-100); the area growth index (growth rate of plaque per unit of time in hours - percentage area/hour); and the area time index (the time, in days, needed to achieve a plaque area of 100% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient and in addition to a full report presenting all the processing data. Dentistry experts evaluated the DenTiUS Plaque software through a usability test, giving the best-scoring questions those related to the workflow efficiency, the value of the online help, the attractiveness of the user interface, and the overall satisfaction.
Conclusions:
The DenTiUS Plaque software allows an automatic, reliable and repeatable quantification of dental plaque levels, providing information about area, intensity and growth pattern. Dentistry experts recognized that this software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies.
... Quantitative light-induced fluorescence (QLF) could possibly provide an alternative solution for plaque assessment. QLF has been previously established for caries detection, caries monitoring and effects of oral hygiene and remineralization approaches 10-13 , but could also be useful for plaque quantification 3,14 and has already shown its capacity and validity compared to oral hygiene indices [15][16][17] . Compared to disclosed plaque, contradictory results concerning its validity have been reported 10,18,19 . ...
... For recognition of plaque-covered pixels in QLF-D and Miratone stained photographs, brightness thresholds of 180 for QLF-D and 90 for Miratone stained images were set by consensus rounds of the authors of the present study and are thus, to a certain extent subjectively. However, a certain level of subjectivity seems to be inevitable for trials using software-aided planimetric measurements for methodological reasons 17 . ...
... All in all, the authors expected a stronger correlation between QLF-D and disclosed plaque without the large deviations detected in the study. The available literature shows that QLF-D has a good validity and reliability for plaque quantification compared to plaque indices [15][16][17] , despite reported differences in plaque quantification between QLF-D and disclosed plaque 14,18,19 . Although the Bland-Altman-analysis of the present study was slightly underpowered, in any case the large interindividual deviations and the higher scattering with increasing amounts of plaque is unlikely to have been influenced by a higher power respectively a larger patient sample. ...
The purpose of the present cross-sectional clinical study was to check the ability of plaque detection and quantification by QLF-D against conventional digital photographs of disclosed plaque in multibracket appliance (MB) patients. 20 patients were included according to the following criteria: (1) upper and lower jaw treated by MB appliance, (2) patients being 16 years of age or older, (3) all central and lateral incisors as well as canines in situ, (4) absence of developmental defects, carious lesions, surface fillings, prosthetic restorations or recessions greater than 1/3 of root length in central/lateral incisors and canines as well as (5) declaration of consent. QLF-D and conventional photographs were analyzed planimetrically regarding plaque coverage on buccal and oral surfaces of central/lateral incisors and canines. The conventional photographs of stained plaque served as gold standard. On average, in QLF-D pictures 20.7% ± 17.4 of the tooth surfaces were covered with plaque, while the conventional photographs of disclosed plaque presented a mean plaque-covered area of 36.2% ± 23.5. The Bland-Altman plot for both imaging modalities showed a very large inconsistent scattering with both negative and positive deviations. The method discrepancy increased with increasing plaque coverage, thus indicating a systematic method error. On average, the deviation of the methods from the optimal line of accordance was −15.5%. In patients wearing MB appliances, there was no clinical significant agreement regarding the plaque-covered tooth surface depicted by QLF-D respectively conventional images of disclosed plaque. Due to the large method discrepancy, QLF-D is currently not reliable for precise plaque quantification in MB patients.
... Several studies indicate that this difference may find its origin in the fact that computer-based plaque analyses are more precise, more objective and more sensitive than classic plaque indices. 80 The Q&H index by Turesky et al 24 is a 0-5 integer assessment of the plaque on labial, buccal and lingual surfaces of each individual tooth. 81 For example, if a particular tooth area is assessed as a score of one and a toothbrush removes 50% of the plaque at this site, the resultant is still one. ...
Objectives:
The aim of this systematic review was to establish the adjuvant clinical effect of brushing with a dentifrice containing purported active-ingredients as compared to a regular sodium fluoride dentifrice with respect to inhibition of overnight dental plaque regrowth from studies with human participants.
Methods:
MEDLINE-PubMed, EMBASE and Cochrane-CENTRAL were searched, up to June 2019. The inclusion criteria were controlled clinical trials with participants aged ≥18 years in good general health. Studies were included that evaluated the effect of toothbrushing with a dentifrice on the inhibition of overnight dental plaque regrowth when an active ingredient was added to the dentifrice as compared to a common sodium fluoride product. Data were extracted from the eligible studies, the risk of bias was assessed, and a meta-analysis was performed where feasible.
Result:
Independent screening of 213 unique papers resulted in 10 eligible publications that provided 14 comparisons. Stannous fluoride and triclosan dentifrices were found as the active ingredients. The descriptive analysis indicated that all, but two comparisons demonstrated an additional effect on the active-ingredient dentifrice. The meta-analysis supported and strengthened these findings. The meta-analysis supported and strengthened these findings. It showed that when plaque was scored digitally a DiffM of -3.15(95%CI[-4.61:-1.69],p<0.001,prediction interval[-5.07;-1.24]). When plaque was scored clinically the DiffM was -0.33(95%CI[-0.49:-0.16],p<0.001, prediction interval[-0.87;0.21]).
Conclusion:
The results of this review demonstrate moderate-quality evidence that brushing with an active-ingredient dentifrice with stannous fluoride or triclosan does provide an added clinically relevant effect concerning plaque inhibition capabilities that surpass the effect of a regular sodium fluoride dentifrice.
