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Diagnosing Developmental Defects of Enamel: Pilot Study of Online Training and Accuracy

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Purpose: The purpose of this study was to assess dentists' ability to correctly identify and classify development defects of enamel (DDE). Methods: The modified DDE (MDDE) index was used to classify enamel defects into two types: (1) enamel hypoplasia—pitted, grooved, or missing enamel; or (2) enamel opacity—translucency of enamel not caused by dental caries or fluorosis (can be either demarcated or diffuse). A panel of six experts selected and scored 36 images using the MDDE, and the consensus score was used as the gold standard score in the evaluation of survey respondents. A short training table was developed to match training images to descriptors for the MDDE. A survey, including the training table, was then distributed electronically to 2,036 U.S. dentists and expanded function dental assistants from the Indian Health Service and 6,174 members of American Academy of Pediatric Dentistry. The percent of correct responses was evaluated for each image. Results: Survey respondents (348 total) showed great variability in correct responses for each image, ranging from 41 to 97 percent, for each category of the MDDE. Conclusions: Enhanced training and calibration on the ability of dental providers is needed to identify the different types of development defects of enamel.
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Document Type: Research Article

Affiliations: 1: Dual trained pediatric endodontist, post-doc fellow, Department of Anesthesiology, University of Michigan School of Medicine, in Ann Arbor, Mich., USA 2: Biostatistician, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Ind., USA 3: Professor, Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, N.Y., USA 4: Emeritus professor, Centre for Paediatric Dentistry, School of Dentistry, The University of Queensland, Brisbane, Australia 5: Associate professor, in both the Department of Preventive Dental Science, College of Dentistry and the Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada 6: Professor, Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA 7: Bawden Distinguished Professor, Pediatric Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, N.C., USA 8: Graduate student, Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Heath, Indianapolis, Ind., USA 9: Professor, Department of Cariology, Restorative Sciences and Endodontics University of Michigan School of Dentistry, in Ann Arbor, Mich., USA;, Email: [email protected]

Publication date: March 1, 2018

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  • Pediatric Dentistry is the official publication of the American Academy of Pediatric Dentistry, the American Board of Pediatric Dentistry and the College of Diplomates of the American Board of Pediatric Dentistry. It is published bi-monthly and is internationally recognized as the leading journal in the area of pediatric dentistry. The journal promotes the practice, education and research specifically related to the specialty of pediatric dentistry. This peer-reviewed journal features scientific articles, case reports and abstracts of current pediatric dental research.
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