Accuracy of Selective Enamel Etching: A Computer-assisted Imaging Analysis
To assess the accuracy of selective enamel etching (SEE) in a laboratory setup simulating clinical conditions. A model with permanent human teeth was fabricated. It included a first mandibular molar with a mesio-occlusal-distal inlay preparation, a maxillary central incisor, and a canine with a class IV and class V cavity, respectively. Two dentists (with 1 year and 10 years work experience) repeatedly (n=10 per cavity) performed SEE with a custom gel that had identical rheological properties as a commercially available phosphoric acid etchant. An intraoral scanner was used for image acquisition. To assess the accuracy of SEE, special software was used (OraCheck, Cyfex, Zurich, Switzerland). Two independent investigators analyzed baseline scans and scans taken of the cavities while the gel was in place. The statistical analysis comprised t-tests, Pearson correlation, and analysis of variance (α=0.05). The level of accuracy, whose average values ranged from 61.1% to 87.0%, showed significant differences between teeth, with the highest level observed in the class V cavity, followed by the class II inlay preparation and the class IV cavity (p<0.001). Across the cavities, no significant correlation was observed between the application time and the accuracy of SEE (p=0.07). This laboratory study suggests that inadvertent conditioning of dentin adjacent to enamel may be common during SEE. Investigations involving larger samples of dentists are needed to corroborate this finding.SUMMARY
Objective
Methods and Materials
Results
Conclusion
Tooth model containing a molar with an inlay preparation (a), a canine with a class V cavity (b), and a maxillary incisor with a class IV cavity (c,d).
Digital impression of the class IV cavity with the custom gel used to simulate SEE in place. Abbreviation: SEE, selective enamel etching.
Bar chart displaying the accuracy of SEE obtained by the two operators in the three cavities. Operator 1 and operator 2 were general dentists with one and ten years of work experience, respectively. Abbreviation: SEE, selective enamel etching.
Contributor Notes
†Tarek Amran and Donat Meier contributed equally to this work.