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PubMed1983

Observations of dental disease and anomalies in 9- to 11-year-old Norwegian children.

Sets of intraoral radiographs consisting of ten periapicals and, in most cases, two posterior bitewings, from 99 girls and 101 boys aged 9-11 years were examined by four dentists. The study was undertaken to quantitate the disease and anomalies present in the sample and investigate the inter-examiner variability of the diagnosis. Each of the examiners independently recorded the disease and anomalies from the radiographs. Knowledge of previous dental treatment and abnormalities noted by the community dental officers were obtained from the children's dental records. The prevalence of disease and anomalies in the sample was low. Considerable examiner variability revealed a need for more objective criteria for the radiographic diagnosis of some of the dental anomalies. Girls had a significantly higher DMFT than boys. Hypodontia was found in 13 children, and dens invaginatus class III/IV (9) was observed on radiographs from 5 children.

Child↗

PubMed1991

[Fissure caries: the correlation of clinical and radiological data].

The goal of this research was to evaluate the conventional means of clinical (mirror and probe examination) and radiological diagnosis (bitewing radiographs) of occlusal caries of first permanent molars during the post eruptive period. These teeth showed colored or non-colored fissures, and none of them had conservative or preventive obturations, or dentinal caries. Four experienced dentists independently evaluated the trials, diagnosed the lesions and advised a treatment. The effective lesions were shown by opening minimal preventive cavities, which were then obturated with amalgam. The results showed the lack of precision for the early diagnostic means of initial pit- and fissures-caries, and differences and errors of evaluation performed by the dental professional with respect to their diagnosis and proposed therapeutic choice. The effective lesions demonstrated the high incidence of pit- and fissure-caries in permanent molars during the post eruptive period.

Adolescent↗

PubMed1984

Long-term effect of orthodontic treatment on crestal alveolar bone levels.

It was the purpose of the present study to evaluate crestal alveolar bone levels in individuals (Study group, n = 104) who had completed orthodontic treatment at least 10 years previously and compare the findings with adults who had untreated malocclusions (Control group, n = 76). Crestal alveolar bone levels were determined on both bitewing and periapical radiographs by direct measurement from the cemento-enamel junction to the alveolar crest. Data from the individual tooth surface measurements were subjected to analyses of variance partitioned on group (Study vs Control), radiographic method, tooth type, dental arch and surface location. There was no significant difference between crestal alveolar bone levels between the study and control group. A Group/Tooth/Surface interaction occurred for the distal surface of molars. The alveolar crest level was significantly less in the orthodontically treated group. Examination of the numerical data suggested that the measured dimension was low relative to normal values, and this effect may have been related to tooth intrusion during orthodontic treatment. It was concluded that orthodontic treatment during adolescence had no detrimental long-term effect upon crestal alveolar bone levels.

Adult↗

PubMed2004

The effect of hereditary disorders on tooth components: a radiographic morphometric study of two syndromes.

OBJECTIVE: The purpose of this study was to compare tooth components (enamel and dentin) in Familial Dysautonomia (FD) and Down syndrome (DS) in order to assess the extent to which each was affected. DESIGN: The design was cross-sectional. The sample consisted of 20 FD patients and 45 DS patients. The control group comprised 250 healthy subjects. Mesio-distal crown width (CW), enamel and dentin thickness and pulp chamber dimensions were measured on standardized bitewing radiographs of mandibular second primary and first permanent molars. Statistical analyses were performed between groups using SAS programs. RESULTS: CW was reduced in both hereditary disorders. In the DS group enamel height (EH) and dentin thickness were reduced. In FD enamel thickness in the primary and permanent molars as well as dentin height (DH) in permanent molars was increased. CONCLUSIONS: In both syndromes the reduction in CW suggests reduced proliferation during tooth germ formation. However, the differences in enamel and dentin thickness suggest that ameloblasts and odontoblasts were affected differently in the later phases of cell function. In FD cell function is stimulated resulting in thicker enamel and dentin. In DS cell function is reduced resulting in thin enamel and dentin.

Adolescent↗

PubMed1991

Caries-inhibiting effects of different modes of Duraphat varnish reapplication: a 3-year radiographic study.

One hundred and sixty 11-year-olds were randomly allocated to two experimental groups, one test (group 1) and one control group (group 2), for a 3-year clinical test comparing different modes of fluoride varnish treatment. In the test group, children received Duraphat varnish treatments 3 times a week, once a year. The children in group 2 were treated with Duraphat every 6 months. During the experimental period, children in group 1 received 9 fluoride varnish applications, and in group 2, 6 applications. Four bitewing radiographs were taken in each child each year for the measurements of the incidence and progression of proximal caries. Repeated fluoride varnish treatment with Duraphat, 3 times a week once a year, appears to inhibit proximal caries progression and development since the children in this group showed even a lower caries status, 1.3 +/- 0.3 DS, at the end of the study compared to 1.6 +/- 0.2 DS at the outset. In group 2, the children increased their caries status from 1.7 +/- 0.2 to 2.4 +/- 0.4 DS during the experimental period. The caries difference was statistically significant (p less than 0.05) between the two groups. A health economic comparison of the two modes of application showed 30% lower costs for the children in the test group based on time used for preventive measures and assumed filling therapy.

Child↗

PubMed1988

Clinical indicators of radiographically detectable dental diseases in the adult patient.

A comprehensive analysis of the relationship between clinical observations in dental patients without symptoms and oral disease as detected by full-mouth and panoramic dental radiographs in a large population of patients has never been reported. Knowledge of these relationships is necessary in the design of a diagnostic decision process (clinical algorithm) that can predict which patients require dental radiographs for the diagnosis of dental caries or periodontal disease to be confirmed or refined. An accurate clinical algorithm could reduce the number of radiographs that are taken of certain routinely seen dental patients without symptoms, thus reducing unnecessary exposure x-radiation as well as potentially reducing health care costs for these patients. A sample of 602 adult men on whom a complete series of panoramic, posterior bitewing, and periapical dental radiographs and an independent oral examination were performed provided the opportunity to evaluate the relationship between clinically observed oral disease indicators and independent radiographic evidence of dental caries and periodontal disease. The analysis suggests that combinations of several clinical indicators can predict with some success which patients without symptoms will benefit most from oral radiographs. The presence of several carious lesions on oral examination was the best predictor of radiographic detection of dental caries. Clinical indicators tht appear to predict radiographic evidence of periodontal disease are clinical measures of pocket depth, mobility, and the patient's denture status. An important finding is that because of the high prevalence of gingivitis and plaque, these indicators were not related to radiographic evidence of periodontal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

A clinical and radiographic evaluation of stainless steel crowns for primary molars.

AIM: This study was performed to evaluate clinically and radiographically the effect of stainless steel crowns placed on primary molars on gingival and bone structures. SAMPLE: 254 crowns were evaluated in a sample of 177 children aged 3.5-12 years old with a mean age of 7 years. METHOD: The clinical parameters that were evaluated were, crown marginal extension, crown marginal adaptation, intact proximal contact, gingival index and the duration of presence of the crowns, together with the oral hygiene index of the child. Bitewing radiographs were viewed for extension and adaptation of crown margins and for evaluating the interproximal bone level. RESULTS: The results of the study showed that interproximal bone resorption was not significantly affected by either crown marginal extension or adaptation, preserving tight proximal contact between molars, oral hygiene level or duration of presence of the crown. On the other hand, there was significant bone resorption when the crown was judged radiographically as non-satisfactory. While oral hygiene level had a significant effect on the gingival index, presence or absence of proper proximal contact did not have an effect on the gingival index. CONCLUSION: It was concluded from this study that stainless steel crowns are still a valuable procedure that has no harmful effect on the gingiva and bone provided that good oral hygiene level was maintained.

Alveolar Bone Loss↗

PubMed1986

The expected benefits from alternative frequencies of bitewing radiograms.

From an analysis of serial bitewing radiograms, we have developed a mathematical model of the initiation and progression of approximal carious lesions in the permanent teeth. The model is used to estimate the expected number of lesions, per individual, not detected until they reach the inner half of the dentin, as a function of the frequency with which radiograms are taken between the ages of 8 and 20 years. If radiograms are performed every 6 months and lesions not restored until radiolucencies appear in the dentin, under 5% of all lesions developing over the 12-year period will reach the inner half of the dentin before detection. If radiograms are taken every 2 years, about 18% of all lesions will have reached the inner half of the dentin before detection. The sensitivity of these conclusions to different assumptions is examined.

Adolescent↗

PubMed1989

In vitro study into the influence of X-ray beam angulation on the detection of artificial caries defects on bitewing radiographs.

Little is known about the influence of errors in angulation of the X-ray beam on the correct diagnosis of interproximal caries defects from bitewing radiographs. In this study radiographs were made of 10 artificial lesions resembling initial interproximal caries defects in mandibular teeth at different projection angles within a range of +/- 15 degrees in horizontal and in vertical direction and presented in a random order to 25 dentists. The result show that the best angle for lesion detection was site-specific with about a 7 degrees tolerance range. On the average, best detection performance was achieved with horizontal angulation perpendicular to the tooth surfaces, and vertical angulation with a positive or negative tilt of 12-15 degrees relative to the perpendicular. Deviations from the best horizontal angle resulted mainly in loss of sensitivity, while vertical misangulations caused mainly a drop of the specificity. The classification of lesions with an actual depth less than halfway into the enamel is influenced to a larger extent than that of deeper lesions.

Dental Caries↗

PubMed1975

Progression of approximal caries in relation to radiographic scoring codes. A pilot study.

Forty pairs of posterior bitewing radiographs taken at the third and fourth annual examinations of three-year clinical trials were assessed twice for caries by one examiner in independent recording sessions. Three or four degrees of caries were recorded in order to determine how different scales of measurement affected aproximal caries progression patterns. The use of one degree of enamel caries, instead of two reduced by about half the percentage of lesions which appeared to have progressed during one year. Most lesions seemed to remain unchanged during the 12 months of observation and those which advanced usually progressed across one demarcation line. Reversals of caries diagnosis and regression of lesions to a lower degree of caries contributed least to the pattern of change between the two examinations. It is concluded that the radiographic scoring codes with two degrees of enamel caries give a better picture of caries progression than those with only one.

Adolescent↗

PubMed1987

Bitewing radiographs and dentists' treatment decisions.

A study involving twenty-one general dentists in private practice in Rochester, New York, was performed to assess the relationship between radiographic evidence of caries and restorative intervention in permanent teeth. Seven thousand three hundred thirty-eight bitewing radiographs taken of 387 patients over the most recent 10-year period were obtained and independently examined by six Eastman Dental Center faculty members as to presence of restorations and caries status of nonrestored proximal surfaces. Patients 20 years of age and younger had significantly lower mean maximum caries penetration scores before restorative treatment when compared to older patients. For all age groups, the mean maximum caries penetration scores indicated that, on the average, restorative treatment was initiated before there were radiographic changes in dentin. There were no differences among the dentists in the study regarding the mean elapsed time between radiographic caries diagnosis and restorative treatment. The random distribution and low number of apparent caries reversals, and the subsequent restoration of 25% of these teeth, suggested that the dentists in this study did not employ systematic remineralization strategies for their patients.

Adolescent↗

PubMed1984

Systems for grading approximal carious lesions and overlaps diagnosed from bitewing radiographs. Proposals for future standardization.

The diagnosis of dental caries from bitewing radiographs has become an important and integral part of many clinical caries trials, particularly in longitudinal studies. Although many seemingly similar systems for grading the degrees of approximal lesions have been used, the diagnostic criteria employed often differ in a number of significant areas. A variety of different conventions have evolved for the treatment of: 1) overlapping surfaces, 2) lesions in the region of the ADJ, 3) subdivision of the radiographic enamel cap and 4) score transitions and caries progression systems. Direct intertrial comparisons may be invalidated by the use of incompatible grading systems. Whilst one rigid grading system will not be suitable for all clinical trials, the use of the appropriate scoring codes and criteria from a standard system may greatly facilitate the comparison and interpretation of results. A comprehensive standard system for the grading and scoring of radiographic diagnoses (compatible with the existing WHO recommendations for the grading of clinically diagnosed lesions) is proposed.

DMF Index↗

PubMed2003

Exposure to fluoridated drinking water and dental caries experience in Australian army recruits, 1996.

OBJECTIVES: The purpose of this study was to investigate a group of young Australian adults to determine their caries experience and measure associations between caries experience and age, gender, socioeconomic status, education level and lifetime exposure to fluoridated water. METHODS: This was achieved through a cross-sectional study involving Australian Army recruits seen for their initial dental examination on enlistment into the Australian Army. A total of 499 recruits had a clinical examination with the aid of bitewing radiographs and an orthopantomograph (OPG). Sociodemographic and fluoride exposure data were obtained via a questionnaire. RESULTS: This study showed that subjects with a lifetime exposure to fluoridated water reported a 23% lower level of caries experience than subjects with no exposure to fluoridated water, with a greater effect on proximal surfaces compared to smooth and occlusal surfaces. Female subjects had a level of caries experience 25% higher than male subjects, while subjects from the lowest socioeconomic background had a level of caries experience 89% times greater than subjects from the highest socioeconomic group. CONCLUSIONS: Although it is not possible to directly establish a causal relationship from a cross-sectional study such as this, the results from this study show a dose-response relationship which suggests that there are benefits of lifetime exposure to fluoridated drinking water through young adulthood.

Adolescent↗

PubMed1989

Effect on approximal caries in teenagers of interrupting a school-based weekly NaF mouthrinse program for 3 years.

The aim of the present investigation was to follow the caries incidence in 126 13-yr-old children who experienced a 3-yr interruption of a supervised weekly mouthrinse program with 0.2% NaF solution (interrupted rinsing-, IR-group). 143 children, 13 yr old, who continuously participated in the NaF mouthrinse program, served as a comparison group (continuous rinsing-, CR-group). Dental caries and restorations were diagnosed on bitewing radiographs; thus only approximal tooth surfaces were considered. The caries incidence over the 3-yr period was 1.84 DFS in the IR- and 1.77 in the CR-group. The corresponding FS-values were 0.67 and 0.25, respectively. Two years later, i.e. when the children were 18-yr-old and the IR-group had had 2 yr back on the school-based mouthrinse program, they were examined again. The difference in caries incidence between 16 and 18 yr of age was still small, 1.32 DFS in the IR- and 1.22 in the CR-group. The corresponding FS-values were 0.63 and 0.49, respectively. Thus, this study showed that the 3-yr interruption of the NaF mouthrinse program resulted in a small, statistically non-significant increase in caries, mostly as regards the number of fillings, on approximal tooth surfaces.

Adolescent↗

PubMed2000

Relationships between radiographic alveolar bone height and probing attachment level: data from healthy post-menopausal women.

OBJECTIVE: To determine the cross-sectional and longitudinal relationships between radiographic alveolar bone height and probing attachment level in a population of healthy postmenopausal women. MATERIALS AND METHODS: The 81 patients in this report were part of a prospective estrogen replacement interventional study. All patients were in good oral health at entry and received annual oral prophylaxis as part of the study. Standard probing measurements were made with a pressure sensitive probe at 6 sites on each tooth. Vertical bitewing radiographs were digitized, and 6 linear measurements corresponding to probing-site measurements were made from the cementoenamel junction to the alveolar crest. These procedures were performed at baseline and at annual intervals for three years. Data were analyzed both by site and by patient. RESULTS: Moderately strong correlations were found between cross-sectional measurements of probing attachment height and radiographic bone height. Correlations were stronger for patient data (r=0.44-0.61) than for site data (r=0.19-0.36). No relationships were found between longitudinal changes in alveolar bone height and attachment level in either the site data (r=-0.10-0.04). or the patient data (r=-0.005-0.10). CONCLUSION: Healthy patients may experience sporadic, temporary changes in attachment level or alveolar bone height which are resolved without one affecting the other.

Alveolar Bone Loss↗

PubMedDate not supplied

A deep model of the incidence of dental caries on proximal surfaces.

As a component of an analysis of the benefits of alternative frequencies of bitewing radiographs to detect dental caries, the authors developed and validated a model to generate an individual's probability distribution for new carious lesions in a year. The model postulates two sources of variability in caries incidence--differences in individuals' underlying caries susceptibilities and a random component. The model is used to examine the nature of caries risk over time. The large random fluctuations in an individual's caries susceptibility from year to year, combined with the random nature of caries attack, makes it difficult to predict future caries experience from the individual's caries experience in the recent past. By modeling the process giving rise to observed incidence data rather than focusing directly on the observed data, i.e., by developing a deep rather than a surface model, the authors have elucidated underlying disease dynamics and provided a basis for generalizing from the particular data used to develop the model.

Adolescent↗

PubMed1985

Comparison between standardized periapical and bitewing radiographs in assessing alveolar bone loss.

Readability and alveolar bone level were compared in 455 sets of standardized radiographs each consisting of four periapical (PA) and two bitewing (BW) films. BW radiographs showed significantly higher proportions of unreadable sites in the canines and the mesial surface of first premolars (P less than 0.0001), while PA radiographs exhibited significantly higher proportions of unreadable sites in the distal surface of second molars (P less than 0.0001). Alveolar bone level was assessable in a total of 10016 sites, and the comparison showed identical readings in 82% of the sites. In the maxilla, a significantly higher proportion of sites exhibited larger bone loss measurements (P less than 0.0001) and more sites with significantly higher mean values (P less than 0.005) in BW than in PA films. Mandibular sites showed the opposite trend. The majority of the sites revealed a Pearson's correlation coefficient (r) ranging between 0.60 and 0.82. No significant difference between mean bone loss measurements in the two types of radiographs for all the sites was found. It was concluded that the two radiographic techniques may be used interchangeably in epidemiologic studies.

Adolescent↗

PubMed1985

Score system for behaviour of radiologically diagnosed approximal carious lesions.

The evolution of systems which monitor changes in the severity of approximal carious lesions diagnosed from serial bitewing radiographs is reviewed. These systems derive a 'score' for each individual lesion based upon the extent of its progression. A new lesion behaviour score system is described which, unlike its predecessors, allows both lesion regression and data from partially overlapped but readable surfaces to contribute to scores. It employs scoring codes from a previously proposed standardized grading system which is compatible with WHO recommendations for grading clinical caries. The score system is designed to be used as a computer program capable of running on a variety of readily available microcomputers; this allows the incorporation of a flexible range of additional options which use the standard data files to calculate scores according to differing conventions. These accommodate variations in: the threshold at which restorative intervention is practiced, the treatment of reversals of caries diagnosis, the threshold of caries diagnosis and the way in which partially overlapped surfaces are scored. These options allow the system to be configured to suit the local needs of different investigations and workers, and also permit the study of the effects of these various methodologies.

Dental Caries↗