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PubMed1989

An in vivo evaluation in children of the HPL bitewing device.

The HPL bitewing device, a new beam-aiming collimating bitewing film holder, has recently been developed. The aims of this study were to assess the practicability of using the new device clinically and to compare the diagnostic yield obtained with the new technique with those obtained using a conventional freehand method and the Rinn XCP instrument. For each of the three techniques a pair of bitewings was taken of 30 randomly selected patients aged 6-15 years. These bitewings were evaluated for technical errors using seven different criteria, including the number and severity of overlapping contacts. The results show that the HPL method produced the greatest number of unoverlapped surfaces and the smallest proportion of moderate and severe overlaps. For five of the seven criteria, the HPL method produced fewer technical errors than the other two methods. Assessment of the acceptability of the procedures to the children revealed few differences between the three radiographic techniques. Further studies of the new technique, involving larger numbers of patients and sequential radiographs, are indicated.

Adolescent↗

PubMed1980

Discriminatory ability of caries diagnosis from bitewing radiographs in caries prophylactic trials.

The discriminatory ability of radiological criteria in common use in clinical trials was tested on 99 female teenagers selected from a larger sample taking part in a 3-year caries prophylactic clinical trial. Four radiological caries diagnostic criteria were selected as generally representative of those in current use following a comprehensive review of the literature. A significant preventive effect was evident from the radiographic examination after 3 years. At this time a significant difference between mean DFS increments was recorded when enamel lesions were omitted (P smaller than 0.05). Although preventive treatment effects were evident at all diagnostic levels, the discriminatory abilities differed. The criterion "involvement of amelodentinal junction but not beyond" was most discriminatory.

Child↗

PubMed1992

Physiological root resorption of primary molars.

Physiological root resorption of primary molars was assessed using bitewings and orthopantomograms. Thirty-six per cent of teeth examined demonstrated reduced root resorption of one or more roots. Excepting the lower first primary molar, the present study recorded a relatively high incidence of uneven root resorption during the exfoliative process, particularly evident for the upper second primary molar. Discrepancy in size between the premolar and its predecessor, as well as the position of the developing permanent tooth in relation to primary root structure influences the pattern of root resorption. Therefore, constant monitoring of teeth demonstrating uneven resorption is required to avoid the complications associated with over-retained teeth.

Child↗

PubMed1977

The construction and use of diagnostic standards for radiographic caries incidence scores.

The aim was to construct and illustrate the use of diagnostic standards for recording of DFS incidence. Separate standards are presented for ranking of subjects; the mean "intermediate" DFS score per subject, which represented the majority decision of three dentists; and a certainty scale for individual tooth surfaces. The scores recorded for 40 sets of posterior bitewing radiographs of children between 13 and 15 years of age by two fourth year dental students and two dental hygienists were compared with the standards. Spearman's rank correlation coefficient reached the critical level of +0.70 in three of eight instances. Only one mean net DFS increment score differed significantly from the mean standard score (p less than 0.05). The level of agreement with the certainty scale for individual surfaces was low. Focusing attention on recording of DFS incidence gives a more severe test of examiners' diagnostic performance. The construction and use of control charts for monitoring the diagnostic level of examiners is suggested.

Adolescent↗

PubMed1979

[Decrease in interdental bone atrophy, radiological survey; statistics from the years 1963-1976 from a Basel public dental clinic].

The material of this study consisted of 300 patients 16 to 39 years of age of the Public Dental Clinic of the City of Basle without destructive periodontal disease. The distance from the cementoenamel junction to the alveolar septum (DJS) was measured on bitewing radiographs at 8 surfaces of the lateral segment. On the radiographs made during the period 1963-1967, the average DJS ranged between 0.93 and 1.49 mm in the 5 age groups. Since 1964-1967, patients have routinely been given theoretical and repeated practical training in prevention of caries and periodontal disease. On the radiographs made during the period 1973-1976, the range of the averages was from 0.65 to 1.01 mm. The decrease of the DJS, 0.35 mm on average, was statistically significant in all 5 age groups.

Adolescent↗

PubMed1984

Caries increment and progression in teenagers when using a prevention- rather than restoration-oriented treatment strategy.

In a group of young teenagers restorative treatment on approximal carious surfaces was postponed until carious lesions were radiographically detected in the dentine, permitting a reallocation of resources to preventive care. The development of new lesions and the rate of progression of unrestored lesions were studied by means of bitewing radiographs obtained at 13 and 16 years of age. Of the radiographically sound surfaces at age 13, 1.3% developed dentinal lesions within the three year period. Approximately 18% of outer enamel lesions and about 55% of inner enamel lesions progressed into the dentine. The number of new lesions as well as the rate of progression varied between groups of patients exhibiting different caries experience at age 13. A total of 1.2 surfaces per patient required restorative treatment according to the treatment strategy applied compared to 5.3 if all radiographically diagnosed lesions would have been restored.

Adolescent↗

PubMed2000

Quality evaluation of young adults' radiographs in Finnish public oral health service.

OBJECTIVE: To evaluate the quality of young adults' radiographs exposed and processed under everyday clinical conditions. SETTING: One administrative unit of the Finnish public oral health service. DESIGN: Two reviewers independently evaluated the radiographs by the same written criteria that were designed as a checklist for on-site evaluations, without any further calibration. SAMPLE: In total, 312 radiographs (178 bitewing, 88 periapical and 46 panoramic) from 1990 to 1996, collected from patient documents of a randomly selected sample of young adults born in 1966-1971. OUTCOME MEASURES: Radiographs were assessed by quality indicators pertinent to the clinical utility as acceptable or unacceptable. If erroneous by some indicator(s) but still contributing to the diagnostic information, a radiograph was rated as diagnostically acceptable. A score of quality points was calculated for each radiograph. RESULTS: The overall kappa statistics for intra-examiner reliability was 0.63, the proportional agreement 83%. For inter-examiner reliability, 0.42 and 71%, respectively. Although the evaluation criteria took the clinical utility of the radiographs into consideration, only 15% of bite-wings, 13% of periapicals, and 2% of panoramics received the maximum quality points. Erroneous film positioning was the most common fault on intraoral radiographs. On panoramics, the most frequent faults were in density and contrast and in patient positioning. The radiological evaluation had only been recorded for less than one fifth of the films. CONCLUSIONS: A proportion of radiographs fell short of the ideal. There is room for improvement in the quality of radiography in order to obtain the greatest possible diagnostic yield from the exposed radiographs.

Adult↗

PubMed1980

Prevalence of juvenile periodontitis in Finland.

The prevalence of juvenile periodontitis was studied in Finland, in an ethnic group representing a uniform Caucasoid population. The study population consisted of the 16-year-old subjects in the county of Uusimaa, population approximately 1,000,000. The screening study was based on the well-organized national dental care service which provides free dental care for all, up to the age of 17. Bitewing radiographs taken of all subjects at the age of 16 were used as the basic material for screening for juvenile periodontitis. Altogether 8,096 pairs of bitewing radiographs were available from the 16-year-old subjects born in 1960-61, representing 56% of the total age group. The radiographs were examined by the author and 28 cases were singled out for thorough clinical and radiographic examination. The following criteria were set for juvenile periodontitis: -- The patient must be in good general health -- Radiographically detectable bone loss more than 2 mm must be demonstrated around more than one tooth -- Local irritants must not be commensurate with the bone loss. Eight cases among the 8,096 subjects fulfilled these criteria giving a prevalence of 0.1%. With 95% confidence this gives an estimate between 0.06 and 0.26%.

Adolescent↗

PubMed1978

Prevalence of chronic periodontitis in 13-15-year-old children. A radiographic study.

The bitewing radiographs of 1,731 English and Danish schoolchildren aged 13--15 years were examined to assess the prevalence of chronic periodontitis. Only one child (0.06%) was found to be affected in comparison with the high prevalence of 51.5% reported by Hull et al. (1975). Minute qualitative changes in the radiographic appearance of the alveolar crest, or changes in the visual representation of the width of the periodontal ligament space are not reliable or valid criteria for assessing chronic periodontitis. Horizontal bone loss observed on radiographs, which can be accurately measured using the cemento-enamel junction as a reference point, is a useful diagnostic criterion for the measurement of chronic periodontitis.

Adolescent↗

PubMed1989

Bitewing radiographs of children taken with and without a film-holding device.

To help minimize radiation exposure, all dental radiographs must yield maximum diagnostic information. Film-holding devices have been recommended as a means of improving the diagnostic yield. Our study compared the diagnostic quality of bitewing radiographs of children taken with and without the aid of a film-holding device. 1014 bitewing radiographs (sizes 0, 1, 2) were taken of 338 children (aged 5-11 years) by senior dental students. Bitewing tabs were used for 554 radiographs and a film-holding device for the remainder. Diagnostic quality was calculated for each radiograph by dividing the number of non-overlapped contacts by the total number present. Both overall mean diagnostic yield and mean diagnostic yield for each size of film were found not to be significantly improved by use of the film-holding device. Position of overlapped contacts on each size of film was not equally distributed (P less than or equal to 0.01) among the contacts present. For size 0 and 1 films, overlap was most frequent between the maxillary first and second primary molars and for size 2 films between the maxillary first permanent molar and second primary molar/second bicuspid.

Adolescent↗

PubMed1999

Durability of tunnel restorations in general practice: a three-year multicenter study.

Twelve dentists, clinically experienced and familiar with the tunnel technique, placed 374 tunnel restorations in permanent teeth. Mean age of the patients was 19.1 years (range 10-74). The filling material used was a glass cermet cement, Ketac Silver. After 1, 2 and 3 years the teeth were controlled by the dentists. The bitewing radiographs from baseline, 1, 2 and 3 years were also analyzed by 2 of the authors, independently. The baseline radiographs showed technical defects in 6% and indicated remaining dentin caries in 8% of the restorations. After 3 years, 305 restorations were accessible for examination. The cumulative replacement rate was 20%. The main reasons for replacement were marginal ridge fracture (14%) and dentin caries (3%). The number of restorations showing untreated progressive caries increased during the study. After 3 years, untreated dentin caries was seen in 28 cases (11%) and almost half of the left enamel lesions showed progression.

Adolescent↗

PubMed1981

Frequency and distribution of proximal overlappings on posterior bitewing radiographs.

4374 proximal surfaces on 791 posterior bitewing radiographs were classified according to overlappings. Six categories were used: 1) no overlapping, 2) blurred contact areas, 3) less than half of the enamel overlapped, 4) more than half of the enamel overlapped, 5) dentin overlapped, and 6) unclassifiable overlappings. Filled surfaces and surfaces not in contact were excluded. Only 19% of the surfaces did not have overlappings 65% exhibited mild overlappings (categories 2 and 3), and 16% severe overlappings (categories 4, 5 and 6). The frequencies of no overlappings varied from 7% to 40% for single tooth surfaces. The relationship between distribution of overlappings and tooth surfaces was statistically significant at the 0.05% level. Principles of excluding overlapping surfaces have been inconsistent in previous epidemiologic studies and clinical trials. The use of exact criteria for exclusion is recommended.

Adolescent↗

PubMed1999

Relationship between oral alveolar bone loss and aging among African-American and Caucasian individuals.

BACKGROUND: The periodontal attachment apparatus consists of the periodontal ligament, alveolar bone, cementum and supra-crestal connective tissue. They are interdependent and provide protection and support to the dentition. It is theorized that the integrity of the periodontal apparatus can be maintained throughout life by exercising comprehensive oral hygiene practices and routine dental care. Additionally, it appears to be unaffected by aging. As a consequence, the investigators performed a study to determine the effects of chronological aging on alveolar bone loss. OBJECTIVE: The present study was conducted to determine the relationship between oral alveolar bone loss, oral hygiene, and aging among African-American and Caucasian populations. METHODS: The population consisted of 229 individuals. There were 131 men and 98 women. With respect to race there were 89 African-Americans and 140 Caucasians. Oral examinations, oral hygiene and missing teeth determinations and bitewing radiographs were performed on all the individuals. Radiographs were digitized and measurements were made from the cementum/enamel junction to the alveolar bone crest. Measurements were made for both the maxillary and mandibular jaws. RESULTS: The results of the study showed a significant multiple linear regression model relationship between oral bone loss and aging. Oral hygiene was a factor, but contributed only slightly to the overall model. Race, gender and the number of missing teeth were not significant variables in the overall model. CONCLUSION: The results of this study suggest age-related alveolar bone loss.

Adult↗

PubMed1985

Longitudinal study of prevalence of enamel lesions in a fluoridated and non-fluoridated area.

The aim of this study was to examine longitudinally the effect of water fluoridation on the prevalence of enamel lesions in children 7-18 yr of age. 93 children in Tiel (1 ppm F-) and 103 children in Culemborg (0.1 ppm F-) were examined every other year at 7, 9, 11, 13 and 15 yr of age. A supplementary examination was carried out when these children reached the age of 18. Children in Tiel had access to water fluoridation from birth. The total number of lesions, including enamel lesions, on the buccal as well as on the occlusal surfaces was approximately the same in both areas in children 15 and 18 yr of age. Approximal lesions were scored on standardized bitewing radiographs. A large proportion of enamel lesions could not be detected on radiographs. In a fluoridated area a high percentage of all lesions remain in the stage of enamel caries lesions. On buccal surfaces 93% and on approximal surfaces 86% of all lesions had not progressed into the dentin. In Culemborg these percentages were 65 for approximal as well as for buccal surfaces. At the initiation of lesions, at younger ages, only a small retardation of the process was observed, but caries progression beyond the stage of enamel caries was markedly reduced in the fluoridated area. No pre-eruptive effect could be observed if the total number of lesions, including enamel lesions, from Tiel and Culemborg were compared.

Adolescent↗

PubMed2006

Dental and periodontal health status in Campanian children and relation between caries experience and socio-economic behavioural factors.

AIM: Our aim was to record oral health situation through mean value of DMFT/dmft, Significant Caries Index (SiC) and CPITN values in a young-population sample in Campania (Italy) and to determine the possible relationship between oral health behaviour, socioeconomic factors and caries experience. STUDY DESIGN: Observational study. METHODS: 101 children (age range 5-18 years) were randomly selected from 10 public schools of the Regional Campanian district and visited at the Paediatric Dentistry Department of Federico II University of Naples (Italy). Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and a WHO CPITN ball-point probe to record the periodontal health of each child. A questionnaire (investigating demographic and oral health behaviour data) was filled. X-ray bitewing were also taken. The comparison of quantitative variables among groups was carried out using the one-way analysis of variance (ANOVA). RESULTS AND STATISTICS: The caries prevalence was 81%; the sample mean values were 3.5 (SD=3.79) for DMFT and 3.8 (SD=3.39) for dmft. The variables influencing statistically DMFT/dmft values in the sample are the following: family socio-economic level, level of educational attainment of children mothers and use of the school canteen service. Most of the examined children show CPITN levels between 0 and 1. CONCLUSION: Our results confirm a high caries prevalence and also a need for preventive and educational programmes to obtain caries decrease.

Adolescent↗

PubMed1992

Restorative treatment thresholds and agreement in treatment decision-making.

It has been recognised for many years that treatment decision-making among dentists often shows wide variation. This study sought to examine the effect of dentists' stated treatment thresholds as a source of variation between them. Twenty dentists made 360 treatment decisions about the approximal surface of extracted teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision-making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.

Adolescent↗

PubMed1984

Reliability of coding depth of approximal carious lesions from non-independent interpretation of serial bitewing radiographs.

In order to help understand the effectiveness of preventive care and the source of variation in treatment decisions, it is important to determine intra- and interexaminer agreement on the presence and depth of radiolucencies on bitewing radiographs when serial radiographs on individuals are available for interpretation. Serial radiographs on 24 subjects were read in succession, and one of four depth codes was assigned to approximal lesions. The radiographs were then read a second time, both by the person who had initially read the radiographs and by a second reader. Intraexaminer agreement on presence of a lesion ranged from 60% to 90%; four of the five readers had an agreement of over 78%. Interexaminer agreement on presence of a lesion ranged from 71% to 84%. Intraexaminer agreement on depth of lesion ranged from 64% to 80%; four readers had an agreement of over 73%. Interexaminer agreement on depth of lesion ranged from 59% to 76%.

Adolescent↗

PubMed2002

A radiographic assessment of the prevalence of pulp stones in Australians.

BACKGROUND: Pulp stones are discrete calcified bodies found in the dental pulp. The aims of this study were to calculate the prevalence of pulp stones in young Australian adults using radiographs, and to report any associations between occurrence of pulp stones and sex, tooth type, dental arch, side and dental status. METHODS: From 217 undergraduate dental students, comprising 123 males and 94 females aged between 17-35 years, 3296 teeth were examined under 2x magnification on bitewing radiographs. Pulp stones were scored as present or absent, and associations with sex, tooth type, dental arch, side and dental status noted. RESULTS: Pulp stones were found in 100 (46.1 per cent) of the subjects and 333 (10.1 per cent) of the teeth examined. Occurrences were rare in premolars (0.4 per cent) but significantly higher in molars (19.7 per cent). Pulp stones were significantly more common in first molars than in second molars, and in maxillary first molars than in mandibular first molars. Carious and/or restored maxillary right first molars and maxillary left second molars displayed higher prevalences of pulp stones than unrestored and intact molars. CONCLUSION: Pulp stones may provide useful forensic information when examining dental records to identify deceased persons.

Adolescent↗