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Results for “Radiography, Bitewing”

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PubMed1990

A reappraisal of the value of the bitewing radiograph in the diagnosis of posterior approximal caries.

The aim of this paper was to re-assess the available literature examining the value of the bitewing radiograph in the diagnosis of approximal caries and to compare the relative values of radiographic and clinical examinations. To this end, results from 29 research studies have been re-presented and tabulated. These results show that the use of the bitewing radiograph is essential if much approximal caries is not to be missed. It is particularly important in the detection of the small lesion which may be managed preventively rather than operatively. Although there is a proper need to ensure that radiographic exposures are minimised, the evidence suggests that both clinicians and epidemiologists must balance this need with the ethical issues associated with failing to employ an established diagnostic aid.

Bicuspid↗

PubMed1994

Effect of a 3-year professional flossing program with chlorhexidine gel on approximal caries and cost of treatment in preschool children.

The aim was to evaluate the effect of chlorhexidine gel treatment on the incidence of approximal caries in preschool children. One hundred and seventeen 4-year-olds, divided into two groups, participated: (1) chlorhexidine gel group (n = 59), and (2) placebo gel group (n = 58). Group 1 was treated 4 times a year with a 1% chlorhexdine gel and group 2 with a placebo gel. Approximately 0.7 ml of gel was applied interdentally by means of a flat dental floss. A control group (group 3), which did not receive any flossing or gel treatment, was also included in the study (n = 116). After 3 years, i.e. when the children were 7 years old, the mean incidence of caries on approximal surfaces (defs), including both enamel and dentin lesions, was 2.59 in the chlorhexidine gel, 4.53 in the placebo gel and 4.20 in the control group (group 1 vs. 2 and group 1 vs. 3: p < 0.01). Mean number of approximal fillings at the end of the study, i.e. when the children were 7 years old, was 0.33 in the chlorhexidine gel, 1.04 in the placebo gel and 0.80 in the control group (group 1 vs. 2: p < 0.01; group 1 vs. 3: p < 0.05). The progression of approximal caries lesions, diagnosed on bitewing radiographs from the age of 5 to 7, was slower in the chlorhexidine than in the placebo gel group (the control group was not evaluated in this respect). A cost analysis, based on the total treatment time in minutes, showed a small gain for the flossing program.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

PubMed1996

Screening for periodontal disease: radiographs vs. PSR.

This study compares the evaluation of periodontal health using bone levels measured on periapical and bitewing radiographs with clinical parameters, such as periodontal screening and recording, gingival indexes, probing depths and attachment levels. The authors found that bitewing radiographs taken within six months of the clinical examination correlated better with the clinical data than older radiographs. However, they concluded that, overall, radiographs are not highly reflective of periodontal status. PSR scores, by contrast, showed significant associations with probing depths and attachment levels. The results support use of PSR as a screening tool for periodontal diseases.

Adolescent↗

PubMed1994

Relationship between dentists' treatment attitudes and restorative decisions made on the basis of simulated bitewing radiographs.

The implicit valuations which dentists place on the outcomes of their treatment decisions may be a major contributory factor in dentists' decisions about when to restore teeth. This study sought to examine the relationship between dentists' treatment attitudes and restorative dental treatment decision making. A group of 20 dentists were asked to indicate teeth in need of filling from 15 simulated bitewing radiographs. The dentists graded their level of certainty about their treatment decision as "definite", "probable" or "possible". Afterwards, the teeth were sectioned and examined using a microscope in order to determine how far through the tooth the caries had penetrated. The gold standard treatment criterion was that caries extending into the dentine of the tooth would require restoration. Receiver Operator Characteristic (ROC) analysis was used to examine the apparent weighting the dentists were giving to decision errors when planning treatment on the basis of bitewing radiographs. The dentists also completed a treatment attitudes questionnaire to determine their views about the relative importance of false negative and false positive treatment decisions. The results suggest that the most appropriate operating point for most of these dentists to achieve an outcome which matched their views about the relative importance of the two types of treatment error would be the point at which a filling would "definitely" be required.

Attitude of Health Personnel↗

PubMed1995

Radiographic evaluation of occlusal caries: effect of training and experience.

The purpose of this study was to investigate what effect differing levels of didactic education and clinical experience have on the ability to diagnose occlusal caries from radiographs. Freshman and senior dental students and dental school faculty were asked to evaluate bitewing radiographs for the presence of occlusal caries and for a recommendation for restorative treatment. The agreement between histologic and radiographic diagnosis was assessed by calculating sensitivity, specificity, accuracy, and interexaminer agreement. It was concluded that dental students and faculty did differ in their abilities to evaluate radiographs for occlusal caries, and that education and clinical experience especially affected interexaminer agreement.

Clinical Competence↗

PubMed1991

Skin exposure and thyroid dose distribution using niobium filtration.

A thermoluminescent dosimetry system was utilized to investigate how much the radiation dose is reduced through the addition of a niobium-based accessory filter to an X-ray unit's conventional aluminum filter. A two-bitewing series was exposed in a tissue-equivalent human phantom. The skin exposures from an X-ray beam with the added niobium filter and a beam with the aluminum filter alone were measured and compared. Thyroid dose distribution was also measured and similarly compared. Utilization of the niobium filter resulted in a significant reduction in skin exposure (p less than 0.001) of 14.8 per cent. Thyroid dose was not lessened by using the niobium filter, however. In fact, in one region of the thyroid it increased significantly.

Filtration↗

PubMed1997

Dental caries on adjacent approximal tooth surfaces in relation to order of eruption.

The occurrence of dental caries on adjacent approximal molar and premolar tooth surfaces was examined on posterior bitewing radiographs. More distal surfaces of the first permanent molars were decayed than adjacent mesial surfaces of the second molars. The appearance of dental caries on adjacent premolar surfaces was related to the order of eruption; the surface that had erupted first was likely to be decayed first. Reports from other studies on adjacent approximal surfaces indicate that this conclusion has a general bearing. It therefore seems important to increase the caries resistance of already erupted teeth by preventive means before and during the eruption of adjacent teeth.

Adolescent↗

PubMed1998

The radiographic determinability of the distance between the pulp horns in the permanent first and second molar teeth.

The purpose of this study was to investigate the determinability of the distance between the pulp horns (PHD) radiographically under routine clinical conditions. This study was carried out on 36 maxillary and 28 mandibular first and second molars which were extracted because of periodontal diseases. Prior to extraction two radiographs were taken from each tooth, one using the bisecting-angle technique and the other by using the bitewing technique. After the extractions, each tooth was burred on the distal and mesial approximal surfaces and pulp horns were found. The distance between the pulp horns was measured (anatomical measurement). Using bisecting-angle and bitewing radiographs, 11 clinicians measured the PHD values of each tooth (radiographic measurement). In our study the residual error in mandibular molar teeth was statistically lower when compared to maxillary molar teeth (p < 0.01). Statistically significant differences were found between anatomic and radiographic measurements (p < 0.01) in maxillary molars. No statistically significant difference was found between anatomical and bisecting-angle measurements in mandibular first and second molars. As a result, it is concluded that bisecting-angle techniques are useful in correctly determining the PHD values in mandibular molars.

Analysis of Variance↗

PubMed1992

Cariogenic changes in dental enamel of boys and girls in relation to salivary properties. II. Radiological examination.

In earlier clinical studies of a group of children subjected to an intense fluoride treatment programme several salivary properties were related to cariogenic changes in the enamel surface, as assessed by mirror and probe. In this study the relationship between salivary parameters and cariogenic changes was investigated on bitewings taken from the same teeth. Inverse correlations were found between the acid producing capacity of the micro-organisms in the saliva (as determined in the Snyder test) and most cariogenic changes detected in bitewings particularly in boys. These radiologically detected changes in enamel were the reverse of those obtained clinically. These discrepancies were explained by differences in sensitivity between clinical and radiological techniques used to diagnose cariogenic changes. In contrast it was confirmed radiologically that for girls the P concentration in saliva and for boys the amount of resting saliva are important for preventing extension of caries into deeper layers of enamel.

Adolescent↗

PubMed1991

Initial development and in vitro evaluation of the HPL device for obtaining reproducible bitewing radiographs of children.

A new beam-aiming and collimating film holder, the HPL device, has been developed to facilitate the production of reproducible serial bitewing radiographs. The device holds two films in the mouth simultaneously and is held in position extraorally. Serial bitewing radiographs of skulls of children aged 7, 10, and 14 years taken with (1) a "freehand" technique, (2) a Rinn film holder, and (3) the HPL device were evaluated for degree of reproducibility, potential diagnostic yield, and technical errors. Compared with the other techniques, the HPL device produced a smaller number of overlapped surfaces and substantially fewer technical errors. In vivo studies of the new device are therefore indicated. The restriction of the field of primary and secondary irradiation may lead to a substantial reduction in absorbed radiation dose compared with other techniques.

Adolescent↗

PubMed1997

An evaluation of bioactive ceramic in the treatment of periodontal osseous defects.

Bioglass particulates were surgically placed in the periodontal osseous defects of 12 patients. The clinical parameters studied were probing depth, attachment level as measured with the Florida Probe, and standardized bitewing radiograph comparisons. Data was collected initially, and at 3-, 6-, and 24-month posttreatment intervals. Statistically significant improvements were demonstrated in all clinical parameters studied. There was a mean probing depth reduction of 3.33 mm, a mean attachment gain of 1.92 mm, and a mean radiographic bone fill of 3.47 mm. Results were stable over the 24-month period. Ease of handling and excellent tissue response were characteristic of the material.

Adult↗

PubMed2002

[Differences in the assessment of restorative dental care].

Caries diagnosis and assessment of restorations show a considerable variation between examiners. It can therefore be questioned whether a professional standard is available on this topic. In this study the judgement of general dental practitioners of the quality of restorative care and the number of adequately and inadequately treated teeth was compared to the judgement of dentists working in teaching institutes. Thirty general dental practitioners and 7 university dentists assessed occlusal photographs and bitewing radiographs of 20 patients with respect to the presence of caries and the quality of restorations. The general dental practitioners gave lower scores on a traditional schoolmark scale than the university dentists, but the latter scored more homogeneous. The agreement (Cohen's kappa) between pairs of examiners was similar for GDPs and experts. The expert group tended to have a more conservative attitude towards the level of restorative treatment to be judged. A univocal professional standard with respect to caries diagnosis and restoration assessment seems difficult to establish.

Clinical Competence↗

PubMedDate not supplied

Computer-assisted densitometric image analysis (CADIA) of previously sealed carious teeth: a pilot study.

Previous studies have shown that occlusal dental caries can be arrested with sealants. Radiographic monitoring must be performed to ensure success. Standardized sequential bitewing radiographs over a 10-year interval of four patients who had sealed composite restorations placed without caries removal were digitized and analyzed using the CADIA algorithm. CADIA values for the 10-year period were analyzed using Analysis of Variance (ANOVA), and showed no significant change in radiographic density for this interval (P > 0.05), which is suggestive of arrested dental caries.

Absorptiometry, Photon↗

PubMed1998

Factors affecting the diagnostic quality of bitewing radiographs: a review.

The bitewing radiograph (BWR) has been used in dental practice for over 90 years and is a widely used technique. This paper outlines the ideal technique for producing reproducible BWR of good diagnostic quality. In particular, it reviews the technical errors that may occur while exposing and processing BWR and the psychological errors that may result when radiographs are viewed. The consequences of these errors, (unnecessary patient exposure to radiation, poor diagnosis and potentially inappropriate treatment) are outlined in detail. Steps to improve the quality of BWR and decrease patient exposure to radiation are given in line with recent recommendations.

Dental Restoration, Permanent↗

PubMed1990

Accuracy in establishing identity by means of intraoral radiographs.

The aim of this study was to evaluate the accuracy in establishing identity of individuals by means of different dental characteristics observed in "ante- and postmortem" bitewing radiographs. Three categories of individuals, based on dental therapy conditions, were considered: Group A) no therapy, Group B) simple therapy, and Group C) complicated therapy. Seven examiners were asked to combine "ante- and postmortem" radiographs and all reports were made on standard forms. The results show that all observers were able to determine identity for the cases in the simple therapy group. In contrast, three observers presented incorrect answers on two cases each in the nontherapy group. Further, two observers were unable correctly to determine identity for four cases in the complicated therapy group. Among a total of seven observers only two observers made no mistakes in any of the groups.

Forensic Dentistry↗

PubMedDate not supplied

Effect of quarterly treatments with a chlorhexidine and a fluoride varnish on approximal caries in caries-susceptible teenagers: a 3-year clinical study.

The aim of this study was to compare the effect of two different dental varnishes on approximal caries incidence in teenagers with proven caries susceptibility during a 3-year period. Two hundred 13- to 14-year-old subjects exhibiting at least two approximal enamel caries lesions were selected to take part in the study. One hundred and eighty subjects participated after informed consent and were randomly assigned to two equally sized groups. One group was treated with a fluoride varnish (FV, Fluor Protector) containing 0.1% F every 3rd month and the participants of the other group were treated in the same mode with a chlorhexidine varnish (CV, Cervitec((R))) containing 1% chlorhexidine and 1% thymol. In total, each subject was treated 12 times during the experimental period. Approximal caries including enamel lesions (DMFS(appr)) were recorded from four bitewing radiographs exposed at the start and end of the study. The mean (+/-SD) caries prevalence at baseline was 2.2+/-3.4 in the FV group and 2.5+/-4.0 in the CV group. After 3 years, the average approximal caries incidence was 2.7+/-3.1 and 3.1+/-3.5 in the FV and CV groups, respectively. The differences at baseline and after 3 years were not statistically significant. In conclusion, treatments every 3rd month with either a fluoride- or a chlorhexidine/thymol-containing varnish showed a promising effect with low approximal caries incidence and progression in teenagers with proven caries susceptibility.

Adolescent↗

PubMed2001

Sex- and age-related differences in primary and secondary dentin formation.

Clinical studies carried out on dentin thickness in adults, as well as experimental studies carried out on ovariectomized animals, indicate that odontoblast activity, like that of osteoblastic cells, differs in the two sexes. To examine the evidence for differences in odontoblast activity before puberty, we have measured dentin thickness and other crown dimensions from bitewing radiographs of the lower first molars in 240 children aged 4-16 years. The radiographs were obtained from pedodontic clinics throughout Israel. Only teeth without caries or fillings were used, and the study population had minimal attrition. The results showed that dentin thickness, measured on the roof of the pulp chamber, was significantly greater in boys than in girls at all ages, and that the differences increased during puberty. The differences remained highly significant even when standardized for crown size. They demonstrate that dimorphism in dentin thickness is present even in the earliest stages of odontogenesis and increase with puberty.

Adolescent↗

PubMed1997

Dental erosion associated with soft-drink consumption in young Saudi men.

This study reports on the causative factors of dental erosion in selected high- (n = 19) and low-erosion (n = 19) subgroups of a larger random sample (n = 95) of young male Saudi military inductees. By means of a questionnaire, the role of various possible factors related to oral health in general, and to dental erosion in particular, was assessed for each participant. Clinical examination included recordings of severity of dental erosion and fluorosis, presence of buccal cervical defects and first permanent molar 'cuppings', DMFT and DMFS, visible plaque index, and gingival bleeding index. In addition, bitewing radiographs, study casts, and intraoral color transparencies were obtained for each individual. Logistic regression analysis showed a strong correlation between the presence of dental erosion and a high level of consumption of cola-type soft drinks. Other statistically significant associated factors, although of less predictive strength, were type of cleaning aid and gingival bleeding index. In subgroup comparisons, dental problems (primarily pain), number of buccal cervical defects, and number of missing teeth were significantly greater in the high- than in the low-erosion subgroup.

Adult↗