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PubMedDate not supplied

Electrosurgical pulpotomy: a retrospective human study.

While the formocresol pulpotomy has enjoyed long-term clinical use and success, concerns over its toxicity and mutagenicity have prompted research into other pulpotomy techniques. The purpose of this study was to observe retrospectively the results of the electrosurgical pulpotomy technique used on primary molar teeth requiring pulp therapy, secondary to carious involvement. The mean age at the time of treatment was 5 years, 11 months and the mean postoperative observation time was 2 years, 3 months. Of the 164 teeth studied, 127 were normal at the last observation visit; 32 had undergone exfoliation; 4 had an abnormality associated with the pulpotomized tooth, but were not considered failures; and 1 was considered a failure. This is a 99.4 percent success rate. Compared to a formocresol pulpotomy study of similar design, the success rate for the electrosurgical pulpotomy procedure in this study is higher at the statistically significant level of p < 0.01.

Child↗
PubMedDate not supplied

The relationship between alveolar bone loss and proximal caries in children: prevalence and microbiology.

The present study describes the prevalence of alveolar bone loss (ABL) in children in relation to caries, contact and space loss. In addition, the microbial composition of the subgingival plaque of 20 sites, from 5 children, is presented. Bite-wing radiographs from 500 children were examined. ABL was evident in: 99 sites from 60 children; > 1 site in 27 children; the maxilla only in 34 children; the mandible only in 17 children; both arches in 9 children; 37 sites with no caries; 4.9 percent of all sites with proximal caries; 15.8 percent of all sites with contact loss; and 20.5 percent of all sites with mesial drift. Anaerobic bacteria were cultured from all 20 sites. No significant differences in the percentages of colony forming units of Actinobacillus actinomycetemcomitans and black pigmented Bacteroides were found among sites with/without bone loss, with/without caries or probing depths smaller/equal or larger than 2.5 mm.

Aggregatibacter actinomycetemcomitans↗
PubMed1995

Prevalence of marginal alveolar bone loss in children referred for treatment to the Paediatric Clinic at the School of Dentistry, University of Otago.

Proximal contact loss due to caries may contribute to the appearance of marginal alveolar bone loss (ABL) in the deciduous dentition. Children referred for treatment to the School of Dentistry, University of Otago, usually have special problems related to caries or management, or both, and the aim of the study was to determine the prevalence of marginal ABL in children treated in this clinic, and to compare it with that found in a previous study in a random sample of New Zealand 5-year-olds. Posterior bite-wing radiographs of 187 children, aged 4 to 14 years, were selected for examination. A total of 1,523 sites, from the distal of the deciduous cuspids to the mesial of the deciduous second molar or the first permanent molar if present, were examined. ABL was recorded when there was complete absence of the lamina dura and the distance from the cemento-enamel junction to the crest of the alveolar bone was > 2 mm. ABL was found in 20.8 percent of the children; 31.9 percent of these sites were adjacent to extensive proximal caries; 83.3 percent were in the maxilla, and 95.8 percent were between deciduous teeth. The youngest age at which ABL was found was 5 years. Among the children with ABL, 48.7 percent had ABL in more than one site. Comparison of the prevalence of ABL at age 5 in the present study (19.2 percent) with the one previously reported for a random population (2.1 percent), suggested that, because of the special characteristics of the children attending the University clinic, students are exposed to an exaggerated image of caries and periodontal diseases in children.

Adolescent↗
PubMed1994

Radiographic detection of occlusal caries: effect of X-ray beam factors on diagnosis.

The aim of this laboratory study was to determine whether the diagnostic potential of bite-wing radiographs in the diagnosis of occlusal caries could be improved by alteration of X-ray beam properties. Bite-wing radiographs of molar teeth with 16 sound and 32 carious occlusal surfaces were taken at conventional settings of 65 kVp, 15 mA and 0.3 s (4.5 mAs) and at 70 kVp, 10 mA and 1.0 s (10 mAs), to produce a darker overexposed film. Results showed that, although the overexposed radiograph resulted in more correct diagnosis of dentine caries, its use increased the number of false-positive diagnoses. More importantly, the experimental exposure factors would have led to an unacceptably high radiation dose to the patient with arguable diagnostic benefit. As such it cannot be recommended in any way for patient examination.

Bicuspid↗
PubMed1995

Is caries prevalence underestimated in today's caries examination? A study on 16-year-old children in the county of Bohuslän, Sweden.

When caries prevalence was higher than today incipient lesions constituted 70% of carious lesions. Incipient lesions were often neglected in caries recordings and hence the true caries prevalence was underestimated. Moreover, it has been shown that there were evident differences in caries status between different areas in the same county though the preventive measures were supposed to be the same (Moberg Sköld et al 1984). To find out if the conditions were the same when caries prevalence has decreased a total number of 240 16-year-old children were examined concerning caries in 1987 and 1990. The results showed that the caries prevalence was still underestimated. Incipient lesions constituted 80% of the total number of carious lesions which was approximately the same as when caries prevalence was higher. The difference in caries status within the country had decreased compared with the study in 1984 (Moberg Sköld et al 1984).

Adolescent↗
PubMed1996

The use of dental radiographs to estimate the probability of cavitation of carious interproximal lesions. Part II: Two patient scenarios.

Diagnosis of a cavitated interproximal lesion is often not confirmed until the tooth is treated. Before treatment, clinicaians and patients are dealing with probabilities which can be estimated from clinical evidence, radiographic evidence, and information found in the dental literature. The probability of a diagnostic test result being correct is affected by the threshold of the test and the pretest probability of the disease in question, which varies with the prevalence of the disease. We illustrate how clinicians can inform themselves and their patients of the probability of a radiographic lesion being truly cavitated based on graphs that summarize the currently available evidence. Dentists who use these graphs can more accurately inform their patients who can then choose the course of care that best meets their individual needs.

Adolescent↗
PubMed1996

Alveolar bone loss and restorative dentistry in the primary molars.

This study examined the relationship between the status of the interproximal alveolar bone and the nature of the adjacent proximal surfaces in the primary molar area. In bite wing radiographs of 354 children, aged 6 to 9 years, 5091 sites were examined; 72.7% of the sites were adjacent to intact proximal surfaces, 14.2% to untreated proximal carious surfaces, and 13.0% to restored proximal surfaces. Marginal alveolar bone loss (ABL) was evident in 26.8% of the children, at 4.0% of the sites. Two thirds of the children with ABL had bone defects in more than 1 site. Males had a significantly higher mean number of sites affected with marginal ABL, per child, than females (mean = 2.4, SE = 0.2 and mean = 1.8, SE = 0.2 respectively). ABL was found adjacent to: 0.8% of the intact surfaces; 16.9% of the carious surfaces; 7.8% of the restored surfaces; 1.8% and 53.8% of the sites without or with proximal contact loss respectively; 3.8% and 30.8% of the sites with or without an adequate amalgam restoration respectively; 4.9% and 25.8% of the sites with an adequate or inadequate crown restoration respectively. The differences in distribution of marginal alveolar bone loss were highly significant (Chi square analysis, p = < 0.0001) for sites with intact, carious or restored sites, and for the presence or absence of contact loss, adequate amalgam or adequate crown.

Alveolar Bone Loss↗
PubMedDate not supplied

CHARGE syndrome: review of literature and report of case. Coloboma, heart disease, atresia of choanae, retarded mental development, genital hypoplasia, ear abnormalities-deafness.

Because of the medical characteristics of this inheritable disorder, the treatment of these patients can be fraught with potential pitfalls. Oral manifestations can include taurodontism of the pulp chambers, retrognathia, palatal constriction with attendant posterior crossbite, frontal tongue posturing, and mouth breathing relating to airway restriction from choanal atresia. The authors describe their treatment of a patient three years of age with a tracheostomy.

Abnormalities, Multiple↗
PubMed1995

Evaluation of three diagnostic methods for initial proximal caries detection in primary molars.

The proximal surfaces of primary molars in 100 selected children were examined for initial caries using three different diagnostic methods: 1--Clinical examination. 2--Fiber-optic transillumination. and 3--Bite-wing radiographic examination. Clinical examination revealed 65 initial proximal lesions, 101 lesions were detected by fiber-optic transillumination, while bite-wing radiographs verified 131 lesions. Agreement between clinical and bite-wing radiographic examinations was 49.6%, while fiber-optic transillumination showed a 77.1% agreement with bite-wing radiographic examination. The three tested diagnostic methods showed no significant difference in detecting proximal lesions in the upper and lower molars, the right and left sides or the mesial and distal surfaces, except for clinical examination which tended to miss more distal lesions.

Chi-Square Distribution↗
PubMed1998

The operative management of caries.

In the management of dental caries preventive treatment must always go hand in hand with operative care. This paper looks at the rationale behind operative treatment and gives some guidelines on when to choose restorative intervention.

Dental Caries↗
PubMed1994

A quantitative analysis of subtraction images based on bite-wing radiographs for simulated victim identification in forensic dentistry.

The comparison between ante- and post-mortem radiographs constitutes an important basis for victim identification in forensic dentistry. Due to the decline in dental caries among children that has occurred in Western countries over the last 20 years, the number of restorations in future populations will be limited. It is likely that this will impede successful victim identification in the future. It was the aim of this study to evaluate a new radiographic technique, subtraction radiography based on bitewing radiographs and determine whether it could provide an objective quantitative measure for victim identification. Bite-wings randomly sampled from a large population of adolescents (13-19 yrs) were video-camera-recorded and digitized. Subtraction images were performed of pairs of bite-wings originating from the same individual (identical images) and from different individuals (non-identical images). The images were separated into two groups, one without fillings (12 identical and 48 non-identical) and one with simple amalgam fillings (15 identical and 60 non-identical). The distribution of grey shades in the subtraction image was used as the parameter for evaluation of homogeneity in the images. Subtraction images derived from identical radiographs were significantly more homogeneous than those derived from non-identical radiographs (p < 0.001) in both group with and without fillings. Although the difference was statistically highly significant, the distribution of grey shades in the two groups overlapped. Thus, the grey shades in the subtraction image cannot per se unequivocally establish the identity of a victim, but may add to the subjective comparison of two radiographs in victim identification.

Adolescent↗
PubMed1999

Detection of caries with conventional digital imaging and tuned aperture computed tomography using CRT monitor and laptop displays.

OBJECTIVE: The purpose of this study was to compare the diagnostic performance of conventional digital images and tuned aperture computed tomography (TACT) slices in caries detection through use of cathode-ray tube monitor and laptop displays. STUDY DESIGN: Forty-two extracted posterior teeth were mounted and imaged with a direct digital radiography system. Conventional digital bitewing projections and TACT slices were acquired. Images were viewed on a high-resolution cathode-ray tube monitor and on an active-matrix laptop display. Eight observers assessed caries status of occlusal and proximal surfaces of the teeth using all combinations of image and display modality. Observers' assessments were compared with the results of histologic examination of tooth sections. Possible differences in receiver operating characteristic curve areas among displays, image modalities, observers, and surfaces were analyzed by means of analysis of variance. RESULTS: There was no statistically significant difference between the diagnostic performances provided by the cathode-ray tube monitor and laptop displays in caries detection (P = .588). In addition, the performances of digital images and TACT slices were not significantly different (P = .843). CONCLUSIONS: Modern active-matrix laptop displays provide diagnostic quality for caries detection comparable to that obtainable with cathode-ray tube monitors.

Analysis of Variance↗
PubMed2004

Secondary caries detection by DIAGNOdent and radiography: a comparative in vitro study.

DIAGNOdent is now well documented for detection of primary occlusal caries, but not as yet for secondary caries. The aim of this study was to investigate the application of DIAGNOdent for in vitro detection of secondary caries. The material comprised 66 extracted teeth: 48 with amalgam restorations and 18 with tooth-colored restorations. Digital images of occlusal surfaces were captured for each specimen. The teeth were mounted in groups of 3 or 4 in plaster blocks simulating their anatomical positions. Bitewing radiographs of each block were assessed for secondary caries by 5 observers. The margins of each restoration were carefully scanned with DIAGNOdent; the site of the highest reading was localized in digital images; and the corresponding values were registered. Marginal integrity and staining were also documented. The restorations were then removed and the teeth were hemi-sectioned. For verification, two observers working together examined all the cavities under a stereomicroscope at 16 x magnification followed by probing. Sensitivity and specificity for DIAGNOdent and conventional radiography were 0.77/0.81 and 0.65/0.81, respectively. Regarding ROC analyses, the Az values were 0.89 and 0.72 for DIAGNOdent and radiography. For DIAGNOdent, the false-positive fraction included only stained teeth. Cohen's kappa statistics disclosed moderate agreement between the 2 methods, with an agreement of 56%. DIAGNOdent tended to give more positive diagnoses than bitewing radiography. The results indicate that DIAGNOdent may be a helpful tool for detecting secondary caries.

Color↗
PubMed1993

Perception of image quality in direct digital radiography after application of various image treatment filters for detectability of dental disease.

This study evaluated dentists' perception of the quality of digitally captured radiographs. Thirty radiographs were taken with the Visualix digital video radiographic system, 10 periapicals for tooth and bone anatomy, 10 periapicals for bone disease and 10 bitewings for dental caries. Three numeric copies were made of each image and treated with three different filters: 'optimize', 'enhance' and 'enhance + smooth', respectively. Four images of the same case were displayed simultaneously in a random sequence on the monitor. Twenty dentists ranked each set of four images on a scale from 1 to 4. In general, most dentists preferred a treated image to the original. The optimized and enhanced images were selected most frequently as first or second choice from the tooth and bone anatomy and bone disease groups. The original image was ranked lowest in more than half (55%) of the series. For the bitewings, the smoothed images were ranked significantly higher. In conclusion, image treatment possibilities should be offered in digital radiography as the majority of dentists preferred a treated image to the original version. The image treatment chosen seemed to be task dependent; less treatment was required to delineate the more subtle tissue differences.

Dental Caries↗