{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:52Z","timestamp":1772169172920,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.18973.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000}},{"DOI":"10.12688\/wellcomeopenres.18973.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000}}],"reference-count":30,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"The Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CPHE\/17\/1\/503352"],"award-info":[{"award-number":["IA\/CPHE\/17\/1\/503352"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns3:p>\n                    Background A new classification called OXIS was proposed for categorizing the interproximal contacts of primary molars, modified for the primary canines and its prevalence was established. No such information is available for the permanent dentition. Hence, the aim was to establish the variations in interproximal contacts of the permanent dentition and thereby modify the OXIS classification of primary molars and primary canines to the permanent dentition. Methods We propose a study-cast-based classification of interproximal contacts of the permanent dentition. Three hundred and forty-three pretreatment casts of patients based on an inclusion and exclusion criteria were selected. Contacts of posterior teeth were classified based on OXIS classification of interproximal contacts, and its modification was used for anterior teeth. Results Among the posterior contacts, the \u2018O\u2019 type of contact was least prevalent, while most prevalent was the \u2018S\u2019 type for second molar-first molar contact, \u2018I\u2019 type for the first molar-second premolar contact, and \u2018X\u2019 type for the second premolar-first premolar contact. Among the anterior contacts, least prevalent was \u2018S1\u2019 type for the first premolar-canine contact, and I type for the canine-lateral incisor and the lateral incisor-central incisor contacts. There was no statistical significance between right- and left-side contacts (\n                    <ns3:italic>P<\/ns3:italic>\n                    &gt; 0.05) while significance was seen between maxillary and mandibular contacts (\n                    <ns3:italic>P<\/ns3:italic>\n                    &lt; 0.05). Similarity of contacts ranged from 5.17% to 10.05%. Conclusion The OXIS classification is applicable to posterior permanent teeth, and its modification is representative of anterior permanent teeth.\n                  <\/ns3:p>","DOI":"10.12688\/wellcomeopenres.18973.3","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T11:10:06Z","timestamp":1724065806000},"page":"176","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of different types of interproximal contacts in the permanent dentition \u2013 a study cast evaluation"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2848-9368","authenticated-orcid":false,"given":"Vignesh","family":"Kailasam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-9662","authenticated-orcid":false,"given":"MS","family":"Muthu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krithika","family":"C","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7365-8397","authenticated-orcid":false,"given":"M","family":"Kirthiga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Aarthi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sankara Aravind","family":"Warrier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"296-309","DOI":"10.1016\/s0002-9416(72)90268-0","article-title":"The six keys to normal occlusion.","volume":"62","author":"L Andrews","year":"1972","journal-title":"Am J Orthod."},{"key":"ref-2","first-page":"197-202","article-title":"OXIS classification of interproximal contacts of primary molars and its prevalence in three- to four-year-olds.","volume":"42","author":"M Muthu","year":"2020","journal-title":"Pediatr Dent."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.12688\/wellcomeopenres.17775.2","article-title":"Modified OXIS classification for primary canines [version 2; 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Shyagali, Orthodontics and Dentofacial Orthopedics, M R Ambedkar Dental College and Hospital, Bengaluru, Karnataka, 21 Nov 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-176\/v2#referee-response-69197","order":0,"name":"referee-response-69197","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21035.r65764, Shalini Garg, Pediatric and Preventive Dentistry, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, 08 Sep 2023, version 1, 2 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-176\/v1#referee-response-65764","order":1,"name":"referee-response-65764","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>M KIRTHIGA<\/b>; \n<i>Posted: 14 Oct 2023<\/i>; \n<b>Reviewer 2 Queries<\/b>  Sample was taken from a specific group of subject requiring orthodontic treatment.(BIASED)  We thank the reviewer for this important observation. We have modified the last paragraph of Discussion, From The possible limitations of this study are that the included samples (study casts) are from the patients who reported for orthodontic treatment and hence would have had increased incidence of malpositions like crowding, spacing, rotations etc. To A major limitation is that the sample was obtained from patients with malocclusion and hence may not be reflective of the general population.  a. Type of malocclusion and molar relationship will affect type of inter-proximal contacts.   Kindly refer to the answer given to Question no. 3a of Reviewer 1. b. It can not be applied to all population groups. We are in consonance with the comment of the Reviewer. Therefore, we have added it to the directions of future research. Kindly refer to the answer given to Question no. 3a of Reviewer 1.  Presence absence and eruption status of permanent third molar will affect type of contacts depending upon age of the patient.  We admit that it would be scientifically relevant to assess the role of third molar in the change in interproximal contacts. Therefore we have added it to the directions of future research. Kindly refer to the answer given to Question no. 3a of Reviewer 1. &nbsp;  Presence of hidden inter-proximal caries can affect the OXIS classification specially with broader contact area.  While we thank the reviewer for this observation, based on the research teams prior experience on OXIS studies on primary teeth \n<sup>1,2<\/sup> where bite wing radiographs were also used to assess the presence of caries, hidden caries did not contribute to change in the type of interproximal contact. However, if the hidden caries progresses to cavitation (Class II), scoring of the contact type becomes challenging. References  Variations in primary molar contact and approximal caries in children: A 3-year prospective cohort study. Kirthiga M, Muthu MS, Kayalvizhi G, Mathur VP, Jayakumar N. Pediatr Dent 2023;45(5):434-9.E48-E50. OXIS contacts and approximal caries in preschool children- A prospective cohort study. Kirthiga M, Muthu MS, Kayalvizhi G, Mathur VP Naveenkumar J, Praveen R. OXIS contacts and approximal caries in preschool children- A prospective cohort study. Caries Res. 2023 January 23; 57(2): 133\u2013140.  &nbsp;  The inclusion and exclusion criteria need to be thoroughly revised .  The inclusion and exclusion criteria have been revised. Kindly refer to the answer given to Question no. 6b of Reviewer 1. &nbsp;  The exact measurement of less or more than 1.5 mm doesn't&nbsp; seem possible with naked eyes.  We are in concurrence with the observation of the Reviewer. Kindly refer to the answer given to Question no. 2 of Reviewer 1.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-176\/v3#referee-comment-5484","order":2,"name":"referee-comment-5484","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.22451.r86450, Baranya Shrikrishna Suprabha, Manipal Academy of Higher Education, Manipal, Karnataka, 10 Jul 2024, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-176\/v2#referee-response-86450","order":3,"name":"referee-response-86450","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>M KIRTHIGA<\/b>; \n<i>Posted: 20 Jul 2024<\/i>;  In the inclusion criteria, add that the casts were of patients seeking treatment for malocclusion, if pre-treatment casts were used. Please specify whether pre-treatment\/post-treatment casts were used.  \n<u><b>Response: <\/b><\/u>We thank the Reviewer for this suggestion. We have modified the sentence by specifying that pre treatment casts were used. From Inclusion and exclusion criteria. The inclusion criteria were: casts of patients with intact contacts, with a full complement of permanent teeth other than third molars, and between the ages of 14 years and 25 years. To Inclusion and exclusion criteria. The inclusion criteria were: pretreatment casts of patients with intact contacts, with a full complement of permanent teeth other than third molars, and between the ages of 14 years and 25 years.  While the code S2 is designated for anterior teeth contact with minor rotation, how was the coding considered in case of mild rotation of posterior teeth?  \n<u><b>Response: <\/b><\/u>While we are grateful to the Reviewer for this query, the rotations of posterior teeth were covered within the OXIS classification. Posterior teeth with broader contact were observed to have S and I type contacts while those with rotations had X type contacts. No changes made.  \u201cWhenever there was any doubt regarding the quantum of measurement with visual inspection, a Williams probe was used to measure the distance and the contact was graded accordingly.\u201d The description of measurement needs to be more specific. How was 1.5mm contact (As per OXIS) measurement done just by visual examination, without measuring each cast?  \n<u><b>Response: <\/b><\/u>While we appreciate the intent of the Reviewer to strengthen the assessment methodology, we would like to reinforce that we used Williams probe only for the borderline cases which could not be categorized with certainty on visual inspection. No changes made.  How was the accuracy of the examiner performing visual examination on orthodontic casts and classifying the contacts ensured? How was the reliability ensured? Was any calibration done with an expert examiner? Please provide inter and intra-rater reliability values.  \n<u><b>Response: <\/b><\/u>We acknowledge the query of the Reviewer. The inter examiner variability a part of the training and calibration process and was 0.92. The reliability was ensured by training and &nbsp;calibration with an expert examiner. The intra examiner reliability data has been provided in the manuscript. This information is available in the paragraph) titled \u201cTraining and calibration of the examiner.\u201d (Page 4 -appended&nbsp; and highlighted below for the Reviewer\u2019s convenience). Before the study began in the university orthodontic department, a single dentist VK was extensively trained and calibrated under the supervision of one of the authors of the OXIS classification, to evaluate the contact areas. The calibration process involved a presentation of the classification and theoretical discussions on its use, followed by practical sessions thereon. Finally, a clinical exercise involving examination and re-examination of the same 20 patient study casts (26 intact contacts per patient), comprising 520 intact contacts, was screened by the same primary investigator on two separate occasions after a three-week interlude. The kappa value to test the intra-examiner variability was obtained as 0.82, which reflected a high degree of agreement. No changes made.&nbsp;  Were the dental casts anonymized during measurement? How was the examiner bias minimized regarding gender and age variation of the patients whose dental casts were examined?  \n<u><b>Response: <\/b><\/u>We are obliged to the Reviewer for the query. The Primary Investigator assessed the casts based on the Out Patient Registration number. This enabled anonymization to the patient details like gender and age, thus ensuring minimization of &nbsp;examiner and observer bias. No changes made.  I understand that the use of dental casts of patients with malocclusion is a major study limitation. Please add in discussion, the applicability of the study findings (in terms of prevalence of various contacts obtained in the study)  \n<u><b>Response: <\/b><\/u>We are obliged to the reviewer for this suggestion. We have modified the Discussion section accordingly. From 'It is plausible to hypothesize that teeth could be at higher risk for caries formation in patients with fixed appliances where broader contacts (\u2018I\u2019 and \u2018S\u2019 types) and rotated teeth (\u2018S1\u2019 and \u2018S2\u2019) are present'. Moreover, contacts would be corrected with orthodontic treatment and it would be of clinical interest to compare these findings with the treated occlusion.  In the introduction, the sentence \u201cThe variations in the contact areas of the permanent dentition might alter caries susceptibility and have orthodontic implications affecting the magnitude of force application, force distribution from one tooth to another and stability of orthodontic treatment\u201d requires a reference.  \n<u><b>Response: <\/b><\/u>We are indebted to the reviewer for this suggestion. We have edited the sentence and have added the following references. From 'The variations in the contact areas of the permanent dentition might alter caries susceptibility and have orthodontic implications affecting the magnitude of force application, force distribution from one tooth to another, and stability of orthodontic treatment' to 'With compelling evidence suggesting that variations in contacts between teeth are important in the development of proximal caries in the primary dentition \n<sup>8-10<\/sup>, it would be of clinical interest to assess it in the permanent dentition. The variations could have orthodontic implications like the stability of orthodontic treatment \n<sup>11<\/sup>, magnitude of force application and force distribution from one tooth to another since the interface between adjacent teeth is due to an equilibrium between the compressive force that each tooth exerts on its counterpart and the resisting force which tries to separate them \n<sup>12<\/sup>.'&nbsp; References added 8. Muthu MS, Kirthiga M, Lee JC, et al.: OXIS contacts as a risk factor for approximal caries: a retrospective cohort study. \n<i>Pediatr Dent.<\/i> 2021; 43: 296\u2013300. 344678477612504 9. Kirthiga M, Muthu MS, Kayalvizhi G, et al.: Variations in Primary Molar Contact and Approximal Caries in Children: A Three-Year Prospective Cohort Study. \n<i>Pediatr Dent.<\/i> 2023;45:434-442. 37904267 10. Kirthiga M, Muthu MS, Kayalvizhi G, et al: OXIS contacts and approximal caries in preschool children- A prospective cohort study. \n<i>Caries Res.<\/i> 2023;57:133\u2013140. 10.1159\/000529160 11. Christine A, Eliades T, Spyridon N. Stability of occlusal outcome during long-term retention: the time-dependent variation of the American Board of Orthodontics index. \n<i>Eur J Orthod.<\/i> 2021; 43(1):1-7. 10.1093\/ejo\/cjaa004 12. Vardimon AD, Matsaev E, Lieberman M, Brosh T. Tightness of dental contact points&nbsp; in spaced and&nbsp; non-spaced permanent dentitions. \n<i>Eur J Orthod.<\/i> 2001;23:305-314. 10.1093\/ejo\/23.3.305","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-176\/v3#referee-comment-5741","order":4,"name":"referee-comment-5741","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome Trust DBT India Alliance [IA\/CPHE\/17\/1\/503352]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}