title: Do the ball-ended probe cause less damage than sharp explorers?-An ultrastructural analysis.
abstract: BACKGROUND
  No evidence about damage caused by ball-ended probes on tooth is available. No study compared probing defects caused by ball-ended probes with sharp explorers during tactile examinations of primary teeth. This exploratory study aimed to compare ultrastructural defects caused by ball-ended probes with sharp explorers during tactile examinations of primary teeth.
  
  
  METHODS
  Forty-nine primary extracted teeth were tactile examined as performed for caries activity assessment. Surfaces were randomly divided into groups based on probe type (ball-ended probe or sharp explorer). Two examiners probed different surfaces using the sharp explorer and the ball-ended probe. The order for examination was randomly determined. Images were captured using environmental scanning electron microscopy (ESEM) before and after probing. Two external examiners evaluated independently the ESEM images and scored them as: 0) no damage, 1) slight marks, 2) distinct marks, 3) marks with discontinuity, 4) enamel break-offs. Multilevel Poisson regression models were used to analyze associations between probing ultrastructural damage and surface type, baseline condition and probe type. Prevalence ratios (PR) were calculated with 95 % confidence interval (CI).
  
  
  RESULTS
  The most common defects observed on the dental surfaces were probing marks without discontinuity (scores 1 and 2). Ball-ended probes caused significantly less severe damage than sharp explorers (PR: 0.28; CI: 0.11-0.76, p = 0.01).
  
  
  CONCLUSIONS
  Ball-ended probes cause less damage than sharp explorers when probing gently dental surfaces of primary teeth.
authors.affiliation: Department of Pediatric Dentistry, Dental School, University of Sao Paulo, Av. Lineu Prestes, 2227, 05508-000, São Paulo, São Paulo, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Mattos-Silveira
authors.affiliation: Department of Pediatric Dentistry, Dental School, University of Sao Paulo, Av. Lineu Prestes, 2227, 05508-000, São Paulo, São Paulo, Brazil.
authors.forename: Marina Monreal
authors.initials: MM
authors.lastname: Oliveira
authors.affiliation: Dental School, Fundação Hermínio Ometto, Uniararas, Av. Dr. Maximiliano Baruto, 500, 13607-339, Araras, São Paulo, Brazil.|Dental School, Guarulhos University, Praça Tereza Cristina, 88, 07023-070, Guarulhos, São Paulo, Brazil.
authors.forename: Ronilza
authors.initials: R
authors.lastname: Matos
authors.affiliation: Dental School, Cruzeiro do Sul University, Rua Galvão Bueno, 868, 01506-000, São Paulo, Sao Paulo, Brazil.
authors.forename: Cacio
authors.initials: C
authors.lastname: Moura-Netto
authors.affiliation: Department of Pediatric Dentistry, Dental School, University of Sao Paulo, Av. Lineu Prestes, 2227, 05508-000, São Paulo, São Paulo, Brazil.
authors.forename: Fausto Medeiros
authors.initials: FM
authors.lastname: Mendes
authors.affiliation: Department of Pediatric Dentistry, Dental School, University of Sao Paulo, Av. Lineu Prestes, 2227, 05508-000, São Paulo, São Paulo, Brazil. mmbraga@usp.br.
authors.forename: Mariana Minatel
authors.initials: MM
authors.lastname: Braga
mesh_terms: D003731:Dental Caries / Q000175:diagnosis; D003743:Dental Enamel / Q000648:ultrastructure; D003762:Dental Instruments / Q000009:adverse effects* / Q000145:classification; D006801:Humans; D011897:Random Allocation; D014094:Tooth, Deciduous / Q000648:ultrastructure*
keywords: Ball-ended probe; Caries lesions; Detection; Explorer; Primary tooth; Tactile examinations