SEARCH · PubMed Health

Results for “Radiography, Bitewing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources

PubMed2002

Accurate diagnosis of occlusal carious lesions--a stereo microscope evaluation of clinical diagnosis.

This study was undertaken to validate the caries status of 214 teeth by serial sectioning and microscopy after caries diagnosis using four methods. Two hundred and fourteen extracted human teeth with varying degrees of caries were mounted in the jaws of nine training manikins. All tooth surfaces were examined and recorded for caries by four dentists using bitewing radiographs, fibre-optic transillumination (FOTI), mirror alone and a mirror and sharp probe on two separate occasions. Thereafter the teeth were serially sectioned and assessed microscopically for depth of caries lesion on a graded score of 0-7. This report assessed the diagnostic outcome of 2,183 observations for occlusal surfaces. Sound diagnoses predominated over unsound until caries was present in the inner half of dentine. Specificity was between 90% and 95% and sensitivity 26% and 50% depending on which diagnostic method was used and where the sound/unsound threshold was set. Negative and positive predictive values were similarly influenced and varied between 53% and 80% and 73% and 90%, respectively. Probit analysis showed no significant differences (P < 0.05) between examiners and diagnostic methods. Diagnosis of occlusal caries undertaken in an in vitro simulated clinical situation is inaccurate until the caries lesion extends deep into the dentine no matter which of the four methods was used.

Chi-Square Distribution↗

PubMed2006

Pattern of dental caries experience on tooth surfaces in an adult population.

OBJECTIVES: To determine the pattern of caries experience across teeth and surfaces in an adult population depending on age and exposure to water fluoridation. METHODS: Between November 2002 and March 2003 a total of 973 subjects aged 17-51 years had a clinical examination using visual and tactile criteria. Subsequent to this examination, bitewing radiographs were taken and viewed separately. Approximal and occlusal surfaces of molars and premolars were examined on the radiographs. RESULTS: Caries experience was relatively low, with mean DMFS scores of 3.21, 5.12, 9.61, 13.04 and 24.35 for subjects aged 17-20, 21-25, 26-30, 31-35 and 36-51 years respectively. The first molar teeth had the greatest caries experience, and occlusal surfaces had more caries experience than approximal surfaces. Subjects with a lifetime exposure to fluoridated drinking water had significantly lower caries experience than those who had no exposure to fluoridated drinking water. CONCLUSION: This study showed that caries prevalence, although relatively low in the study population, was found predominantly in occlusal surfaces, with an increasing prevalence in approximal surfaces of posterior teeth in older subjects. Subjects with a lifetime exposure to fluoridated drinking water had a lower level of caries experience than those with no exposure to fluoridated drinking water, and this was more noticeable in approximal surfaces than occlusal surfaces.

Adolescent↗

PubMedDate not supplied

Radiographic assessment of the alveolar bone height in children and adolescents with familial dysautonomia.

PURPOSE: Familial dysautonomia (FD) is a progressive neuropathy, characterized by somatic and skeletal abnormalities, and by a variety of oral and diet disturbances. The purpose of the study was to assess the alveolar bone height at the molar areas of children and adolescents with FD. METHODS: The distance from the cemento-enamel junction (CEJ) to the alveolar bone crest (ABC) was measured on routine diagnostic bitewing radiographs of nine males and seven females with FD (mean age = 122 months) and in those of two matching groups (C1 = 119 months; C2 = 122 months). RESULTS: The mean values for the maxilla were significantly larger than those in the mandible. A positive significant correlation was found between the CEJ-ABC measurements of the primary and the permanent teeth, and between the CEJ-ABC measurements and age. The mean values per patient for the CEJ-ABC distances of the FD group were smaller than the control groups, but the difference was not statistically significant. The CEJ-ABC measurements in the primary and the permanent molars were smaller in the FD group, and in the premolars and permanent cuspids they were larger than those in the two control groups. These differences were not statistically significant. No differences were found between the FD and the control groups in the primary cuspids. CONCLUSIONS: The alveolar bone height of children and adolescent with familial dysautonomia does not differ from that of healthy controls.

Adolescent↗

PubMed1996

Interpretation of bitewing radiographs. Part 1. Evaluation of the presence of approximal lesions.

OBJECTIVE: Bitewing radiographs are the main tool for approximal caries detection. However, interpretation of findings is affected by numerous factors, such as beam angulation, exposure conditions, morphologic variations, etc. The objective of the present study was to compare the ability to detect virtually identical, artificial lesions in different tooth surfaces. METHODS: The in vitro model included preparation and radiologic evaluation of approximal artificial lesions in premolars and molars in depths ranging from 0.00 mm to 1.50 mm. RESULTS: Significant differences were found in the prospect of a lesion detection between the different lesion depths (p < 0.0000) and between the different surfaces examined (p < 0.05). The interaction between lesion depth and tooth surface was significant at the 0.0001 level (ANOVA with repeated measures). CONCLUSIONS: The results indicate that initial approximal lesions of uniform size are more readily detected in premolars than in molars and that the chance of an incipient lesion to remain undetected is twice as high in molars than in premolars.

Analysis of Variance↗

PubMed1996

Dentists' stated restorative treatment thresholds and their restorative and caries depth decisions.

OBJECTIVE: This study examines the relationships between stated restorative treatment thresholds of 16 dentists and both their restorative decisions and caries depth determinations for approximal tooth surfaces based on bitewing radiographs. METHODS: Sixteen dentists independently examined 15 pairs of experimental bitewing radiographs. They separately recorded restorative and dental caries depth decisions for 4,864 unrestored approximal tooth surfaces, 304 identical surfaces per dentist. In addition to caries depth and restorative decision data, these dentists provided their restorative thresholds using a five-point scale. RESULTS: Three dentists stated it would be appropriate to restore enamel lesions, nine would wait until caries had reached the dentinoenamel junction, and four would wait until caries extended into the dentine. Although dentists stating an enamel restorative threshold intended definitely or probably to restore relatively more surfaces and recorded relatively more surfaces with dentinal caries, ANOVA analyses revealed that the differences among the restorative and the depth means according to the restorative thresholds were not significant. Considerable variation existed in both the restorative and depth decisions among the dentists in each threshold group. CONCLUSION: Although interesting trends occurred in the restorative and depth decisions relative to the stated thresholds, this study suggests, like others in Europe, that these thresholds cannot be taken at face value to explain restorative decisions.

Analysis of Variance↗

PubMed1992

Overhanging amalgam restorations in young adults attending a periodontal department.

An important factor affecting plaque retention is the presence of amalgam restorations which are poorly contoured at the gingival margin. The aim of the study was to investigate the occurrence and effects of overhanging amalgam restorations in young adults. One hundred patients, aged 20-29 years, referred to the Periodontal Department, School of Dentistry, Belfast were investigated. Bitewing radiographs were used to examine the restorative status of the approximal surfaces of premolar and permanent molar teeth, excluding third molars. Fifty-seven per cent of the patients investigated had at least one amalgam overhang and 27 per cent had three or more overhangs visible on the radiographs. One hundred and seventy-eight (25 per cent) of the restored approximal surfaces had detectable amalgam overhangs. The mean bone level-amelocemental junction (ACJ) distance related to the approximal surfaces with overhangs was 1.77 (s.d. 1.0) mm and 37 (32 per cent) of these surfaces had bone levels which were greater than 2 mm from the ACJ. The mean bone level-ACJ distance for the other approximal surfaces of the teeth with overhangs was 1.63 (s.d. 1.2) mm. The mean bone level-ACJ distance for matching control surfaces on contralateral teeth was 1.86 (s.d. 1.2) mm. It was concluded that overhanging amalgam restorations were common in the restorations of young adults (20-29 years old) referred for periodontal treatment but were not associated with increased levels of bone destruction.

Adult↗

PubMed1992

Factors influencing the likelihood of successful decisions to treat dentin caries from bitewing radiographs.

The purpose of this study was to describe the role played by the ability to estimate caries depth in successfully deciding to treat dentin caries when making use of bitewing radiographs as a diagnostic test. A 10% random sample (n = 444) of Dutch dental practitioners was sent a two-wave questionnaire concerning radiographic caries diagnosis and restorative treatment decision making. The second wave consisted of simulated bitewing radiographs of 105 tooth surfaces with and without dentin caries according to two measuring standards: (a) a micro-radiographic "gold" standard and (b) a norm of expert observers. The dentists were asked to diagnose caries at 4 depths of penetration using a 5-point certainty scoring system to measure diagnostic ability; and to make a treatment decision for each surface. The overall response was 61% (273). A regression analysis was carried out using the chance per dentist of correctly deciding to treat dentin caries as the dependent variable. The degree of agreement with the experts' diagnosis of radiographic caries depth was used to create variables measuring diagnostic ability. Five significant (P less than 0.05) variables explained 60% (R2 = 0.60) of the variation in decision making. The best diagnostic ability variable explained 47% of the variation while the treatment criterion reportedly used explained 3%. We conclude that the ability of practitioners to interpret radiographs plays a major role in treatment decision making and that their reported treatment decision making criteria should not be taken at face value.

Adult↗

PubMed1995

Recall intervals, dental hygienists and quality in child dental care.

Decline in dental disease and the need to provide dental care efficiently suggest changes in clinical and administrative routines in public dental care provision for children. A field project in Norway demonstrated productivity gains after the introduction of individualized recall intervals and using dental hygienists to conduct recall examinations. The purpose of the present study was to assess changes in the quality of dental health outcome and changes in the quality of the process of dental care provision. Recall intervals were increased from a target of 12 months to 16 and 18 months in two districts. Dental hygienists undertook all recall examinations and referred to dentists those patients who required operative care. Bitewing radiographs were inspected for all 18-yr-olds who were examined in 1989, 1990 and 1991 (n = 956) and for those who were examined before the changes were implemented in 1987 (n = 300). For each child, approximal caries on 24 surfaces was scored according to a 4-point severity scale. Clinical records were examined to determine what treatment had been provided. For each year after the changes were implemented, the quality of health outcome was assessed by comparing the radiographic caries prevalence and the number of sound surfaces with 1987 data. Quality in the process of care provision was indicated by the treatment decisions for approximal caries and by the proportion of uninterpretable surfaces on radiographs for each study year. The mean number of sound surfaces increased over time. A declining proportion of sound surfaces was restored over the study period, and almost all caries lesions extending deep into dentine were restored. Radiographic quality improved during the project period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Evaluation of a computer program for caries risk assessment in schoolchildren.

The 'Cariogram' is an interactive PC program for caries risk evaluation. It takes into account the interactions between caries-related factors and expresses a graphic assessment of the risk. The aim of this study was to assess the caries risk in schoolchildren using the Cariogram and to evaluate the program by comparing the caries risk assessments with the actual change in DMF. A 2-year prospective study on 446 schoolchildren, 10-11 years old, was conducted. At baseline, data on general health, diet, oral hygiene and use of fluoride were obtained. Saliva analyses included mutans streptococci and lactobacilli counts, buffer capacity and secretion rate. DMFT and DMFS were calculated from records and bitewing radiographs. Scores were entered and caries risk was assessed. Re-examination for caries was done after 2 years. The children were divided into 5 groups according to the assessed caries risk at baseline. Where the Cariogram predicted a 0-20% (high risk), 21-40%, 41-60%, 61-80% and 81-100% (low risk) chance of avoiding new lesions, 8, 35, 42, 73 and 83%, respectively, had no new lesions 2 years later. Logistic regression analyses were carried out. When the Cariogram was included, only two factors, the Cariogram (p < 0.001) and the DMFS at baseline, i.e. past caries experience (p = 0.001), turned out to be significantly associated with caries increment. The Cariogram was the most powerful explanatory variable. When the Cariogram was excluded, lactobacillus count, mutans streptococci, diet intake frequency and DMFS at baseline were significantly associated with caries increment. The Cariogram predicted caries increment more accurately than any included single-factor model. How this finding can be translated into daily practice in the best and most practical way is a matter for future research.

Analysis of Variance↗

PubMed1997

Adaptation and radiographic evaluation of four adhesive systems.

OBJECTIVES: The purpose of this study was to compare microleakage, gap formation, thickness of the adhesive layer and its radiographic appearance associated with four adhesive restorative procedures for class I cavities. METHODS: Adhesive systems with easy handling characteristics were selected for the restoration of class I cavities in extracted third molars. Bitewing radiographs were taken of each tooth and four observers were asked to assess the presence of the adhesive layer. Microleakage, gap width and the thickness of the adhesive layer of each restoration were measured upon sectioning of the teeth. RESULTS: Microleakage in the experimental restorations was minimal. The thickness of the adhesive layers and gap formation varied among different adhesive systems. The adhesive system with self-etching primer produced the highest percentage gap-free restorations. Thick adhesive layers could be detected on the radiograph. ROC analysis of the results validates the diagnosis from the radiograph. CONCLUSIONS: The four restorative systems performed well in the prevention of microleakage. The use of a resin modified glass-ionomer cement base did not prevent gap formation compared with the all-etch bonding systems used in this study. The presence of an adhesive layer contributed to the prevention of gap formation, independently of the bonding system used. Thick adhesive layers could be detected on the radiograph.

Acid Etching, Dental↗

PubMed1999

The effect of multiple examinations on the diagnosis of approximal caries and the restoration of approximal surfaces.

OBJECTIVE: The aim of this study was to determine the effect of multiple examinations on sensitivity and specificity in the diagnosis and restoration of approximal caries. STUDY DESIGN: In 2 studies, dentists examined bitewing radiographic films for approximal caries and the need for restoration. To model the clinical situation of multiple examinations over time, all groups of combinations of 2 to 10 dentists were constructed. Mean sensitivity and specificity were determined. In addition, 2 new variables were created: the first, "sensitivity any," was calculated by assigning a correct diagnosis for disease if any dentist in the group identified the diseased surface correctly; the second, "specificity all," was calculated by assigning a correct response only when all dentists in the group correctly identify a nondiseased surface. RESULTS: The sensitivity and specificity means were the same for all group sizes. The "sensitivity any" means increased monotonically from group size 1 to group size 10, whereas the "specificity all" means decreased continually. There was a statistically significant difference between sensitivity and "sensitivity any" and between specificity and "specificity all" for all group sizes in both studies. CONCLUSIONS: Multiple examinations increase the number of carious surfaces correctly diagnosed and the number of surfaces appropriately restored; however, multiple examinations also increase the number of sound surfaces diagnosed as carious and the number of intact surfaces receiving restorations.

Decision Making↗

PubMed1997

Caries progression in 12- to 16-year-old schoolchildren in fluoridated and fluoride-deficient areas in Brazil.

UNLABELLED: Water fluoridation may reduce the rate of caries initiation, but relatively little is known of its effect on rates of caries progression through the enamel and the dentin. OBJECTIVE: This longitudinal study was designed to compare rates of caries progression in fluoridated and fluoride-deficient areas. METHODS: Approximal caries progression was evaluated on two standardized sets of bitewing radiographs taken at a 12-month interval of 290 12- to 16-year-old Brazilian schoolchildren. Pitts' scoring system was used to measure caries progression on conventional bitewing images. Caries progression data on the occlusal, free-smooth, and approximal surfaces of the anterior teeth were collected via clinical visual examinations. RESULTS: The mean rate of approximal caries progression in school-children living in fluoridated areas (0.54) was found to be 62% lower than that in children from fluoride-deficient areas (1.41). When progression rates were adjusted for the initial number of decayed surfaces per subject, differences were statistically significant for lesions located at the inner half of the enamel at baseline (11% in the fluoridated areas vs. 16.5% in the fluoride-deficient areas). Multivariate logistic regression analysis revealed that residence in a fluoride-deficient area remained a significant risk factor for caries progression after controlling for caries prevalence (D1FS), number of cavitated carious lesions, whether tooth type was molar or premolar, and toothbrushing frequency. CONCLUSIONS: These results suggest that water fluoridation reduces the rates of caries progression through the enamel and dentin, but the effect was more pronounced for lesions in the inner enamel than for those in the dentin.

Adolescent↗

PubMed1993

Diagnosis of caries progression from serial bitewings: a comparison between teachers and practitioners.

Approximal caries progression is best monitored from serial bitewing radiographs but the factors influencing dentists' interpretation of these films is poorly understood. Three radiographic tests were shown to a non-randomised group of 28 practitioners (GDPs) and 21 (predominantly part-time) teachers of conservative dentistry. Test 1 investigated an appreciation of the effects of irradiation geometry change on radiolucency depth. Test 2 detected evidence of irradiation geometry change from approximal overlaps and using this as a validity check for comparing serial films. Test 3 was designed to compare the effect of lack of radiolucency progression on the prescription of restorations. The results showed that in test 1, 43% of GDPs and 29% of teachers, despite being told of irradiation geometry changes, ignored the unreliability of the radiolucencies and recommended restorations. In test 2, 54% of GDPs and 71% of teachers ignored evidence of irradiation change. In test 3, 75% of GDPs and 76% of teachers ignored radiographic evidence of static carious lesions and prescribed restorations. Statistically there was no difference in the decision making outcomes between the two groups. There is cause for concern that objective radiographic data does not appear to be used correctly by the majority of dentists in planning treatment decisions.

Adolescent↗

PubMed1997

Visible-light curing units: correlation between depth of cure and distance between exit window and resin surface.

Study 1) The depth of proximal cavities was measured on previously taken bitewing radiographs. Study 2) By means of a scrape test, the relationship between depth of cure and irradiation distance was examined with four different curing units and two different restorative resins. Study 3) The microhardness of one of the polymerized resins was measured 0.5 mm below the free surface of the filling and then at 1.0 mm, 1.5 mm, 2.0 mm, and so forth until the resin became so soft that no hardness could be recorded. The hardness at each 0.5-mm level was recorded in relation to irradiation distance. 1) The cavity depth was most often 4-5 mm in lower premolars, 5 6 mm in upper premolars and lower molars, and 5-7 mm in upper molars. In the latter teeth, 15% of the cavities were > or =8 mm deep. 2 and 3) The depth of cure decreased moderately and in a linear manner with increasing irradiation distance. An irradiation distance of 12 mm reduced the depth of well-cured resin only by about 1 mm as compared with close contact between exit window and surface of resin.

Adult↗

PubMed2002

A comparison of Kodak Ultraspeed and Ektaspeed plus dental X-ray films for the detection of dental caries.

BACKGROUND: Using the fastest dental X-ray film available is an easy way of reducing exposure to ionizing radiation. However, the diagnostic ability of fast films for the detection of proximal surface caries must be demonstrated before these films will become universally accepted. METHODS: Extracted premolar and molar teeth were arranged to simulate a bitewing examination and radiographed using Ultraspeed and Ektaspeed Plus dental X-ray films. Three different exposure times were used for each film type. Six general dentists were used to determine the presence and depth of the decay in the proximal surfaces of the teeth radiographed. The actual extent of the decay in the teeth was determined by sectioning the teeth and examining them under a microscope. RESULTS: There was no significant difference between the two films for the mean correct diagnosis. However, there was a significant difference between the means for the three exposure times used for Ultraspeed film. The practitioners used were not consistent in their ability to make a correct diagnosis, or for the film for which they got the highest correct diagnosis. CONCLUSIONS: Ektaspeed Plus dental X-ray film is just as reliable as Ultraspeed dental X-ray film for the detection of proximal surface decay. The effect of underexposure was significant for Ultraspeed, but not for Ektaspeed Plus. Patient exposure can be reduced significantly with no loss of diagnostic ability by changing from Ultraspeed X-ray film to Ektaspeed Plus X-ray film.

Dental Caries↗

PubMed1996

Interpretation of bitewing radiographs. Part 2. Evaluation of the size of approximal lesions and need for treatment.

OBJECTIVE: The decision to treat initial approximal carious lesions is based mainly on interpretation of bitewing radiographs. In a previous report, it was shown that artificial approximal lesions of uniform size are more readily detected on radiographs in premolars than in molars. The objective of the present study was to compare the ability to evaluate the depth of similar size artificial lesions on radiographs and reach decisions concerning treatment, in premolars and molars. METHOD: Clinicians were asked to evaluate on radiographs, the size of in vitro prepared artificial lesions, and decide at which point they would perform a restoration. RESULTS: Significant differences were found in the evaluation of lesion depth between different tooth surfaces. The interaction between lesion depth and tooth surface originated from the examiners' trend to score same size lesions as penetrating deeper into the tooth in premolars than in molars. The probability of the examiners to decide on restorative treatment in shallow lesions (0.25 mm, 0.50 mm) was higher in premolars than in molars. CONCLUSIONS: The findings suggest that clinicians evaluate initial lesions as being deeper and more prone to treatment in premolars than in molars.

Analysis of Variance↗

PubMed1996

The role of caries recognition: treatment decisions from bitewing radiographs.

OBJECTIVE: To describe the effect of the ability to estimate caries depth from bitewing radiographs on restorative treatment decisions. METHODS: A 10% random sample of Dutch dental practitioners (n = 444) was sent a two-part questionnaire based on an analytic approach to radiographic caries diagnosis and restorative treatment decision making. In the second part the dentists were asked to diagnose radiographs of 105 tooth surfaces with and without dentine caries and then to make a treatment decision for each surface. A regression analysis was carried out using the negative predictive value (TN/[TN + FN]) of the restorative treatment decision for dentine caries as the dependent variable. RESULTS: The mean negative predictive value for the dentists' proposals from radiographs to leave surfaces untreated was 0.77 (SD 0.05; min. 0.60, max 0.87). Nine significant (P < 0.05) variables explained 65% (R2 = 0.65) of the variation in decision making. One diagnostic ability variable explained 48% of the variation found. CONCLUSIONS: Dentists appear to take the seriousness of errors in restorative decisions into account when deciding on treatment. The ability of dental practitioners to identify and discriminate between lesions in the inner half of the enamel and the outer half of the dentine, however, plays a dominant role in their treatment decision making.

Decision Making↗

PubMedDate not supplied

Effects of beam collimation on image quality.

PURPOSE: The purpose of this study was to determine the effect of three film-speed/collimator combinations on image quality, based on reviewer preference and diagnostic quality, based on caries detection. METHOD: Two hundred sixteen proximal surfaces were evaluated for the presence and severity of carious lesions on bitewing-simulated projections using D-speed film/circular, E-speed film/rectangular, and E-speed film/circular collimation. Matched films by model type were ranked, based on reviewer preference. Preference data were analyzed using Friedman's test, while the caries detection data were analyzed using a 3 x 3 x 3 x 6 ANOVA model and the kappa statistic. Variability components of the ANOVA were used to determine inter- and intra-rater reliability. RESULTS: Inter- and intra-rater reliability were 90.9 and 98.7%, respectively. Each of the film-speed/collimator combinations had average preference rankings that were significantly different from one another for each criteria (p < 0.001), with E-speed film/rectangular collimation consistently ranking highest and E-speed film/circular collimation consistently ranking lowest. There was excellent agreement in caries detection among the three film-speed/collimator combinations (kw = 0.92, kw = 0.94). CONCLUSION: Results from the subjective comparison indicated that E-speed film with rectangular collimation ranked highest for film resolution, overall appearance, and choice for caries diagnosis, while E-speed film with circular collimation ranked lowest. Caries diagnosis was comparable among the three film-speed/collimator combinations.

Analysis of Variance↗