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PubMed1994

Sexual dimorphism in mesiodistal dentin and enamel thickness.

This study evaluates sexual dimorphism in mesiodistal diameter, enamel thickness and dentin thickness of the permanent posterior mandibular dentition in order to gain a better understanding of variation in mesiodistal tooth size. The results relate to a sample of 59 males and 39 females, 20-35 years of age. Bitewing radiographs of the right permanent mandibular premolars and molars were illuminated and transferred at a fixed magnification to a computer via a video camera. Enamel and dentin landmarks were identified and digitized on the plane representing the maximum mesiodistal diameter of each tooth. The results showed significant sex differences (p < 0.01) in mesiodistal diameter favouring males over females. Dimorphism was more pronounced for the molars than for the premolars. Enamel thickness, which is 0.4-0.7 mm greater for the molars than premolars, shows no significant sex differences. Dentin is significantly thicker in males than females, and is 3.5-4.0 mm thicker in molars than premolars. It is concluded that sexual dimorphism in mesiodistal tooth sizes is due to differences in dentin thickness and not enamel thickness.

Adult↗

PubMed2006

Is pre-term labour associated with periodontitis in a Danish maternity ward?

OBJECTIVES: To reveal differences in periodontal status and presence of subgingival bacteria in a Scandinavian population of women with pre-term birth compared with women who delivered at term. MATERIALS AND METHODS: Twenty-one women with pre-term labour (before week 35) and 33 women with term labour (between weeks 38 and 41) were included in this case-control study. Periodontal measurements included plaque index (PlI), probing pocket depth (PPD) and bleeding on probing (BOP). Inter-proximal distances from the cemento-enamel junction (CEJ) to the marginal bone crest (MBC) were measured on bitewing radiographs. In 31 patients (16 cases and 15 controls) the subgingival plaque was analysed using "checkerboard" DNA-DNA hybridization. RESULTS: Differences between the two examined groups were found related to "Twin births" (p=0.0064) and "Smokers" (p=0.03). None of the periodontal measurements showed any association. Significant differences were found concerning presence of Tannerella forsythensis, Treponema denticola, Peptostreptococcus micros, Streptococcus intermedius, Streptococcus oralis, Streptococcus sanguis and Capnocytophaga ochracea but when defining sites with >10(5) bacteria as heavily colonized, no statistical difference was found between the two groups. CONCLUSION: A relation between pre-term birth and periodontitis was not revealed in the present study.

Adult↗

PubMed2002

Clinical performance of a compomer and amalgam for the interproximal restoration of primary molars: a 24-month evaluation.

OBJECTIVES: To evaluate the clinical performance of a compomer material (Dyract) in comparison with dental amalgam (Contour) for management of proximal caries in primary molars in young children. SETTING: General dental practice, and a dental hospital paediatric clinic. METHOD: This was a prospective study. A split mouth design was used with identical pairs of minimal Class II cavities, of matched tooth type in the same dental arch, usually diagnosed with the use of bitewing radiographs. Seventy-eight pairs of restorations were completed of which 60 pairs were available for evaluation after 24 months. RESULTS: Comparable retention rates were observed for both Dyract and amalgam. The retention rates were high for both materials, with only four amalgam and two Dyract restorations failing over 24 months. Significantly better marginal integrity (P < 0.05) was observed for Dyract compared with amalgam with no significant differences between the two materials for recurrent caries, wear or surface texture. CONCLUSIONS: Dyract seemed to be a suitable alternative to amalgam for proximal restorations in primary molars of young children for use in general dental practice.

Child↗

PubMed2006

Smokeless tobacco (snuff) use and periodontal bone loss.

OBJECTIVE: The aim of the present cross-sectional study was to investigate a possible association between the use of Swedish moist snuff and periodontal bone loss. MATERIAL AND METHODS: The study was carried out on 84 apparently healthy men in the age range 26-54 years, 25 current snuff users, 21 former snuff users, and 38 never-users. The periodontal bone height was evaluated from bitewing radiographs measuring the distance from the cement-enamel junction (CEJ) to the periodontal bone crest (PBC) at pre-molars and molars in each quadrant of the dentition. RESULTS: The mean (95% confidence interval (95% CI)) CEJ-PBC distance was 1.00 (0.87-1.13), 1.12 (0.97-1.26), and 1.06 (0.95-1.16) mm for current users, former users, and never-users, respectively. The association between snuff use and bone height level controlling for age was not statistically significant (anovaF = 0.3, p > 0.05). There was, further, no statistically significant difference between light and heavy exposure users controlling for age (anovaF = 1.0, p > 0.05). CONCLUSION: Our observations suggest that the use of Swedish moist snuff is not associated with periodontal bone loss.

Adult↗

PubMed1997

Restorative certainty and varying perceptions of dental caries depth among dentists.

OBJECTIVE: The question of whether dentists who most frequently identify tooth surfaces for definite restoration perceive dental caries as significantly deeper than other dentists is assessed. METHODS: One group of 20 dentists independently examined 145 unrestored approximal tooth surfaces on 16 bitewing radiographs and recorded their restorative and depth decisions. Another group of 15 dentists similarly scored 304 unrestored surfaces on 30 bitewing radiographs. Each group of dentists was later divided into four subgroups according to the number of surfaces designated for definite restoration by each dentist. RESULTS: As the number of tooth surfaces designated for definite restoration increased, mean caries depth (P < .05 for the high vs low subgroups) and the percent of dentinally carious surfaces increased, while the percent of surfaces assessed as sound decreased. Dentists with the lower numbers of surfaces designated for definite restoration came closest to the true histologic mean caries depth of the examined tooth surfaces. CONCLUSIONS: Dentists who designated high numbers of approximal tooth surfaces for definite restoration assessed caries as deeper than other dentists, and deeper than was proven histologically.

Analysis of Variance↗

PubMed1998

Enamel thickness of the posterior dentition: its implications for nonextraction treatment.

This study describes mesial and distal enamel thickness of the permanent posterior mandibular dentition. The sample comprised 98 Caucasian adults (59 males, 39 females) 20 to 35 years old. Bitewing radiographs of the right permanent mandibular premolars and first and second molars were illuminated and transferred to a computer at a fixed magnification via a video camera. Enamel and dentin thicknesses were identified and digitized on the plane representing the maximum mesiodistal diameter of each tooth. The results showed that there were no significant sex differences in either mesial or distal enamel thickness. Enamel on the second molars was significantly thicker (0.3 to 0.4 mm) than enamel on the premolars. Distal enamel was significantly thicker than mesial enamel. There was approximately 10 mm of total enamel on the four teeth combined. Assuming 50% enamel reduction, the premolars and molars should provide 9.8 mm of additional space for realignment of mandibular teeth.

Adolescent↗

PubMed2001

Sensitometric and clinical evaluation of a new F-speed dental X-ray film.

OBJECTIVE: To compare the sensitometric properties, diagnostic efficacy and image quality of the InSight (F-speed) and Ektaspeed Plus (E-speed) dental X-ray films (Kodak Eastman Co, Rochester, USA). METHODS: Characteristic curves were constructed, using manual and automatic processing, in order to compare film speed and average gradient. The diagnostic yield was compared by assessment of endodontic file length. Endodontic files, sizes 10 and 15, were placed at the root apex or 1.5 mm short. The exposure time for the InSight films was 20% lower than that of Ektaspeed Plus. Seven dentists rated the position of file tip using a 5-point confidence scale. ROC data were analysed by means of analysis of variance. The null hypothesis was rejected when P<0.05. In order to compare the image quality, 100 pairs of bitewing radiographs of the left (using Ektaspeed Plus) and the right sides (using InSight) of the same patient were made. Four dentists viewed the radiographs and the data were analysed using Kendall's coefficient of concordance. RESULTS: InSight was faster than Ektaspeed Plus. It was an E-speed film when processed in manual conditions and an F-speed film when processed automatically. The films had comparable average gradient. No significant difference was found in the diagnostic yield using the two films (P=0.648). Two observers showed a significant preference for Ektaspeed Plus. CONCLUSIONS: The first results of the new InSight film are promising: the exposure time can be reduced by 20% in comparison with Ektaspeed Plus at no detriment to diagnostic efficacy.

Absorptiometry, Photon↗

PubMed2002

Caries rates related to approximal caries at ages 11-13: a 10-year follow-up study in Sweden.

Predicting future caries risk is a difficult but important clinical task. The aim of this study was to analyze radiographically the relationship between approximal caries (4d-7m) at ages 11-13 (baseline) and future approximal caries. We followed 534 individuals prospectively through annual bitewing radiographs from 11 to 22 years of age. Two measures were used: individual-based incidence of the first new approximal caries lesion and surface-based incidence of approximal lesions. In the group with no approximal caries lesions at baseline, the individual-based incidence was 19 first new approximal lesions/100 person-years; the corresponding value for those with 3 approximal lesions at baseline was 71. Individuals with no approximal lesions at baseline developed 3.1 new lesions/100 tooth surface-years; the corresponding value for those with 3 lesions at baseline was 7.7. The highest risk for developing new approximal lesions was within the first 2 years after baseline.

Adolescent↗

PubMed1992

Radiometric classification of alveolar bone health.

A radiograph-based classifier for discrimination between normal and diseased alveolar bone was developed. The alveolar bone health of dry mandibles was rated, by consensus of two trained observers, as normal or diseased. Bitewing radiographs of mandibular quadrants were digitized and regions of interest (ROIs) of the alveolar bone between the first and second permanent molars outlined. Gray-scale histograms for the ROIs were computed, and a classifier based on these histograms was developed. Two observers (independently) used only the classifier to rate the bone as being normal or diseased. These ratings were compared with the original ratings of trained observers who viewed and scored the actual alveolar bone. The sensitivity (the ability to detect diseased alveolar bone), specificity (the ability to detect normal alveolar bone), and accuracy were 0.90 or greater, indicating good agreement with subjective visual assessments of dry mandibles. These results suggest that this procedure may be applicable for evaluations of bone health in humans.

Adult↗

PubMed1994

The effect of NaF and SMFP toothpastes on three-year caries increments in adolescents.

A three-year double blind clinical caries trial was undertaken to compare the anticaries efficacy of three types of active agent, namely sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and the combination of NaF plus sodium trimetaphosphate (TMP), using two fluoride levels (1000 ppm F and 1500 ppm F). The prime objective of the study was to determine whether there was any difference in the anticaries efficacy between NaF and SMFP. The second objective was to assess the effect on caries protection of the incorporation of TMP into a NaF dentifrice formulation. The study was carried out to FDI protocol and involved 4,294 children aged 11-12 years at outset. These participants had been selected from a pool of 6,212 potential subjects on the basis of caries experience and dental eruption pattern. They were stratified by sex, examiner, presence of calculus and caries, and allocated at random to one of the six toothpastes under study. Clinical examinations were carried out at baseline and thereafter annually for 3 years. Bitewing radiographs of a subset of children were taken at baseline and at the end of the study. The outcome measure for the study, DMFS increment, was defined as the increase in caries over three years, taking into account changes occurring on individual tooth surfaces. After three years, clinical-only data for 3,517 children were available for the calculation of caries indices. The mean three-year DMFS increment for subjects using a dentifrice containing NaF alone was 6.4 per cent lower than for those using a dentifrice containing SMFP. The difference between the NaF+TMP users and the SMFP users was 8.1 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1999

Interdental caries incidence and progression in relation to mutans streptococci suppression after chlorhexidine-thymol varnish treatments in schoolchildren.

The aim of this study was to evaluate interdental caries incidence and progression in relation to the effect of antibacterial varnish treatments in schoolchildren anticipated at caries risk. After a screening procedure, 110 healthy children (8-10 years) with moderate and high counts of salivary mutans streptococci (MS) were invited to join a 2-year longitudinal study. At baseline, MS were enumerated at all mesial interdental sites of the first permanent molars with a chair-side technique. The children were then treated 3 times within 2 weeks by interdental spot applications with a 1% chlorhexidine/thymol-containing varnish (Cervitec). Follow-up samples of saliva and plaque were collected 1, 3, 6, and 12 months after onset of treat. Caries prevalence, incidence and progression of the selected approximal surfaces were scored from bitewing radiographs exposed at baseline and after 2 years. Sixty-three children of the same age formed a non-varnish-treated reference group. Reduction of caries incidence and progression was dearly dependent on the outcome of the antibacterial treatment. A significantly (P< 0.01) higher progression score was found among children who exhibited a less marked suppression of interdental MS levels compared with those with high suppression and the children of the reference group. The results suggest that a suppression of MS in interdental plaque may be an important event to prevent and arrest approximal caries development in schoolchildren at risk. Monitoring the effect of antibacterial agents in a site-specific way could therefore be advocated.

Analysis of Variance↗

PubMed1997

Direct evidence concerning the 'major role' of fluoride dentifrices in the caries decline. A 6-year analytical cohort study.

The role of fluoride (F) dentifrices in caries decline was investigated by assessing the effect of variation in their use on caries scores among teenagers. The material comprised 211 subjects aged about 11 years at base line and 18 years at the last examination. Pairs of posterior bitewing radiographs were assessed by one examiner. Information concerning dental health behavior was collected by questionnaire and about treatment received from dental records. A reversal of the traditional DFS gender difference occurred during teenage years. Multivariate regression analyses showed an inverse relationship between variation in F dentifrice use and current decay (D1S) at age 18 years (P < 0.04) and with caries incidence per year (D1FS) during the whole observation period (P < 0.02). Total explained variance in 6-year deltaD1FS scores was 29.8%, of which variation in toothbrushing behavior contributed 1.8 percentage points. While confirming the multifactorial nature of dental caries, these results also provided quantitative evidence for the role of variation in F dentifrice use in caries incidence and decline.

Adolescent↗

PubMed1991

Automatic analysis of radiographic images: II. Software implementation and testing on bitewing radiographs.

A prototype, completely automatic image-analysis system for dental bitewing radiographs was implemented in 'C' on a Unix workstation. A multiple layer hierarchical image model was created in software for each radiograph using production rule-based knowledge. The highest model layer formed an English-like description of anatomical structures including tooth type, interdental alveolar bone crest margins and spaces. A representation of spatial relationships between anatomical structures was formed, providing a method for comparing similar regions of a patient in serial, but not absolutely standardized, images. In 31 clinical radiographs, the system automatically identified 93% (193) of all available interdental spaces which are the key image regions for model creation. Each image required 2 minutes of processing time. The reproducibility of finding 34 interdental spaces in five films revealed one error. Further work is required to improve the recognition rate of the interdental regions towards 100% and to develop automatic comparisons between areas of change (disease?) in serial films.

Humans↗

PubMed1996

Restorative treatment decisions from bitewing radiographs--performance of dental epidemiologists and general dental practitioners.

The object of the study was to compare the performance of a group of eight trained and standardized dental epidemiologists making restorative treatment decisions with that of a group of 20 general dental practitioners. Both groups read the same set of 15 pairs of simulated bitewing radiographs. For each approximal tooth surface image, the examiners were asked to record on a six-point rating scale the confidence with which they would or would not place a restoration. A histological gold standard was available, based on microscopic evaluation of sections of the extracted teeth used for study. The reference criterion was "caries into dentine". The only statistically significant differences in performance between the two groups were at the "definitely" plus "probably" restore rating level. For the proportions of correct decisions out of all treatment decisions at this level, the epidemiologists scored 89% compared with 86% for practitioners (P < 0.01) while for Youden's J index, the corresponding values were 0.44 and 0.34 (P < 0.05). The findings suggest that the benefits in improved performance from examiner training may be small.

Bicuspid↗

PubMed1992

Diagnosis of dentin involvement in occlusal caries based on visual and radiographic examination of the teeth.

The purpose of the present study was to examine the validity of visual, radiographic and combined visual-radiographic examination of occlusal caries, with special reference to the diagnosis of dentin lesions, using the microscopic diagnosis after sectioning the teeth as validating criterion. Thirty extracted permanent molar teeth with signs of occlusal caries were selected and radiographed using a standard method similar to bitewing. Ten dentists, five from the Department of Cariology and Endodontics and five from the Department of Pedodontics, were asked to make a visual, radiographic and combined visual-radiographic caries examination with an interval of at least 1 month between different examinations. The teeth were sectioned bucco-lingually and the caries assessed as enamel or dentin lesion in a stereomicroscope. The sensitivity/specificity of the diagnoses of dentin lesions was 0.72/0.41 for the visual, 0.66/0.50 for the radiographic, and 0.86/0.64 for the combined visual-radiographic examinations. The Receiver Operating Characteristic (ROC) method revealed a statistically significant difference between combined visual-radiographic examination and the two other, but not between the isolated visual or radiographic examination. It is concluded that the combined use of visual and radiographic examination is better than either visual or radiographic examination alone.

Dental Caries↗

PubMed2004

Rectangular collimation and radiographic efficacy in eight general dental practices in the West Midlands.

INTRODUCTION: Rectangular collimation is recommended in order to reduce radiation doses to patients. However, anecdotal reports suggest that it may result in more retakes, with a possible net increase in patient dosage. METHOD: To test this hypothesis, eight general dental practitioners were recruited to participate in a project. Each took 25 pairs of bitewing radiographs of patients before and 25 after fitting rectangular collimators to their x-ray machines. Double-pack films were used so that duplicates could be examined. These were assessed by a consultant oral radiologist according to the National Radiographic Protection Board (NRPB) grading system for positioning and general film quality. RESULTS: Initially, positioning quality was above the target level for six of the eight dentists; however, for all but one, this dropped after using rectangular collimation. General film quality was of a lower overall standard initially. Using rectangular collimation had an effect on general film quality but the direction and size of this varied among the dentists. CONCLUSION: It was concluded that amongst the participating dentists, although numbers of retakes increased by 7%, there would be a net reduction in dosage to patients following rectangular collimation.

England↗

PubMed1992

Changes in radiographic bone level in orthodontically treated teenagers over a 4-year period.

In 1984 the prevalence of subjects with radiographic bone loss was assessed in all 14-year-old schoolchildren in Oslo (n = 2767). An overrepresentation of subjects with bone loss was found among those undergoing orthodontic treatment. The aim of the present study was to assess the effect of orthodontic treatment on the prevalence and incidence of radiographic bone loss during the following 4-yr period. Bitewing radiographs from 1984, 1986, and 1988 of a sample of 438 subjects from the original population constituted the study material. Bone loss was recorded if the distance from the alveolar crest to the cementoenamel junction exceeded 2 mm. 111 subjects (25.3%) had received orthodontic treatment. In 1984, 18 of them (16.2%) exhibited bone loss. The corresponding figure for the 327 non-treated children was 14 (4.3%). The incidence of subjects with new tooth sites with bone loss among those with a record of previous orthodontic treatment was 1.1% and 3.2% in the periods 1984-86 and 1986-88, respectively. Among those who had never received such treatment the incidence figures were 3.2% in the period 1984-86 and 2.0% in the last period. The results indicated that the majority of the bone loss observed during or immediately after termination of orthodontic treatment was transient in nature.

Adolescent↗

PubMed1996

The difference between clinical and bitewing detection of approximal and occlusal caries in Royal Air Force recruits.

This paper reports on differences between the clinical and radiographic detection of caries, on both occlusal and approximal surfaces, in a cohort of Royal Air Force (RAF) recruits (mean age 18.9 years). It was found that the clinical examination detected only 30 per cent of the total lesions found by both methods combined. The radiographic examination found 201 per cent extra occlusal dentinal lesions and 192 per cent extra approximal dentinal lesions. In those recruits where caries was evident, the mean number of dentinal lesions found after the clinical examination was 1.0 compared to 2.7 lesions after the radiographic data were added. It was concluded from these results that radiographs are essential for assessment of the prevalence of both approximal and occlusal caries in service recruits. The epidemiological effect, in this age group, of the lower sensitivity of the clinical examination was to underestimate the overall DMFT by 7.8 per cent, although nearly three times as many dentinal lesions were diagnosed from radiographs as were detected clinically.

Adolescent↗