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PubMed2003

Comparison of the diagnostic potential of direct digital and conventional intraoral radiography in the evaluation of peri-implant conditions.

The aims of this study were to examine whether viewers agreed on details seen in direct (real time) digital and conventional film radiographs of implants, and whether there were differences in agreement between the systems. Intra-oral radiographs of implants were exposed both as direct digital and conventional film radiographs. Fifty pairs of radiographs with similar projection and exposure were selected, showing 59 implants. Ten viewers assessed the radiographs separately and noted eight different details. The viewers showed very high agreement in their assessments of radiographs of each technique separately, and there were no statistically significant differences. However, there was a tendency to stronger agreement in the direct digital radiographs in four assessed points out of eight. The patients' experience of having radiographs exposed with the two methods was also studied by questionnaire. The patients' opinions on the two techniques did not differ statistically. This study shows that digital radiography has at least equal diagnostic yield compared to film radiography.

Adolescent↗

PubMed2000

Apical inflammatory root resorption: a correlative radiographic and histological assessment.

AIM: To assess the reliability of routine single radiographs in the diagnosis of inflammatory apical root resorption by correlating the radiographic and histological findings. METHODOLOGY: The material comprised serial and step serial sections of plastic-embedded root-apices with attached apical periodontitis lesions that were prepared for a previous study and the diagnostic radiographs. The histological sections of 114 specimens were analysed by light microscopy and categorized into three groups: (i) those without any resorption (0); (ii) those with moderate resorption (+); and (iii) those with severe resorption (+ +). The radiographs were examined by a separate examiner and graded with a similar categorization of no resorption (0); moderate (+); and severe (+ +) apical resorption. RESULTS: Radiographically, 19% of the teeth were diagnosed as having apical inflammatory root resorption, whereas histologically, 81% of the teeth revealed apical inflammatory root resorption. A correlative radiographic and histological assessment (n = 104) revealed a coincidence of diagnosis in 7% of the specimens and noncoincidence of diagnosis in 76% of the specimens. CONCLUSIONS: The results indicate that routine single radiographs are not sufficiently accurate or sensitive to consistently diagnose apical root resorptive defects developing as a consequence of apical periodontitis.

Dental Cementum↗

PubMed2003

The conservative approach to managing unerupted lower premolars -- two case reports.

General dental practitioners frequently refer patients with unerupted premolars for specialist management. The frequency of unerupted lower second premolars in 15-year-old children has been cited as high as 9.7%. Two cases are discussed involving unilateral unerupted premolars, which initially appear to be in unfavourable positions. The first patient was referred at 16 years of age and presented with an unerupted lower left first premolar positioned along the lower border of the mandible. The second patient presented with an unerupted distally inclined, horizontally positioned second premolar impacting on the roots of the first permanent molar. Both cases were reviewed without any treatment, and both premolars erupted into excellent positions. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases where premolars are unerupted or impacted, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.

Adolescent↗

PubMed2000

Radiographic localization of unerupted mandibular anterior teeth.

The parallax method and the use of 2 radiographs taken at right angles to each other are the 2 methods generally used to accurately localize teeth. For the parallax method, the combination of a rotational panoramic radiograph with an occlusal radiograph is recommended. This combination involves a vertical x-ray tube shift. Three case reports are presented that illustrate: (1) how this combination can accurately localize unerupted mandibular anterior teeth, (2) how a deceptive appearance of the labiolingual position of the unerupted tooth can be produced in an occlusal radiograph, (3) how increasing the vertical angle of the tube for the occlusal radiograph makes the tube shift easier to discern, (4) why occlusal radiographs are preferable to periapical radiographs for tube shifts, and (5) how localization can also be carried out with 2 radiographs at right angles to each other, one of which is an occlusal radiograph taken with the x-ray tube directed along the long axis of the reference tooth.

Adolescent↗

PubMed2003

Prevalence of third molar impaction in orthodontic patients treated nonextraction and with extraction of 4 premolars.

The purposes of this study were to confirm that premolar extraction treatment is associated with mesial movement of the molars concomitant with an increase in the eruption space for the third molars and to test the hypothesis that such treatment reduces the frequency of third molar impaction. Lateral cephalograms, panoramic or periapical radiographs, and study models made before (T1) and after (T2) treatment and a minimum of 10 years postretention (T3) of 157 patients were selected from the postretention sample at the Department of Orthodontics of the University of Washington, Seattle. Treatment for 105 patients included the extraction of 4 premolars; the other 53 were treated nonextraction. These patients represented all the extraction and nonextraction patients in the sample who had at least 1 third molar at T1 or T2 and who showed evidence of full eruption or closure of the root apex at T2 or T3. Student t tests showed higher scores for third molar impaction (P <.01), less mesial movement of the molars from T1 to T2 (P <.01), and smaller retromolar space at T2 (P <.001) in both arches of the nonex patients than in the ex patients. Similarly, molar movement was more mesial from T1 to T2 in the maxilla (P <.01) and in the mandible (P <.05), and the retromolar space was larger in both arches (P <.001) of the patients with eruption than in those with impaction of the third molars. Our results suggest that premolar extraction therapy reduces the frequency of third molar impaction because of increased eruption space concomitant with mesial movement of the molars during space closure.

Adolescent↗

PubMed2001

Performance of RVGui sensor and Kodak Ektaspeed Plus film for proximal caries detection.

OBJECTIVE: A high-resolution charge-coupled device was used to compare the diagnostic performances obtained with Trophy's new RVGui sensor and Kodak Ektaspeed Plus film with respect to caries detection. STUDY DESIGN: Three acquisition modes of the Trophy RVGui sensor were compared with Kodak Ektaspeed Plus film. Images of the proximal surfaces of 40 extracted posterior teeth were evaluated by 6 observers. The presence or absence of caries was scored by means of a 5-point confidence scale. The actual caries status of each surface was determined through ground-section histology. Responses were evaluated by means of receiver operating characteristic analysis. Areas under receiver operating characteristic curves (A(Z)) were assessed through analysis of variance. RESULTS: The mean A(Z) scores were 0.85 for film, 0.84 for the high-resolution caries mode, and 0.82 for both the low resolution caries mode and the high-resolution periodontal mode. These differences were not statistically significant (P =.70). The differences among observers also were not statistically significant (P =.23). CONCLUSION: The performance of the RVGui sensor in high- and low-resolution modes for proximal caries detection is comparable to that of Ektaspeed Plus film.

Analysis of Variance↗

PubMed2002

Oral and clinical characteristics of a group of patients with Turner syndrome.

OBJECTIVE: The loss of the X chromosome in girls with Turner syndrome (TS) affects the shape and the size of craniofacial structures. Few studies have been reported on female patients with TS in South America. Records of odontologic alterations of 23 Argentinian patients with TS were compared with those of 25 girls in a control group, and associations were made with medical indications. STUDY DESIGN: Oral clinical diagnoses were completed with periapical, occlusal, panoramic, and orthopantomograms; urine and blood determinations were performed by conventional methods. RESULTS: Blood phosphorus and calcium levels were altered, and osteoporosis was detected. In some patients, TS was associated with autoimmune thyroiditis. Control subjects had normal blood and urine values. The decayed, missing, and filled permanent surfaces index for temporary teeth was statistically higher for the control group. About 78% of the patients had hypoplasia, 65% had reduced root length and bifurcated roots, and 100% had high arch palate. Incisor asymmetry was also observed. CONCLUSIONS: Medical and laboratory indexes are essentially indicative of hormone alterations. TS patients have a particular oral anatomy that could be closely related to an alteration in calcium and phosphorus metabolism.

Adolescent↗

PubMed2000

Longitudinal radiological study of the oral health parameters in an elderly Finnish population.

In the oldest elderly, an increase in the number of remaining teeth may increase oral infection foci. The aim of this follow-up study was to examine the radiologically detected oral health condition of a group of home-living elderly in Helsinki at 5-year intervals. The population of this study comprised 103 home-living elderly people, all participants of the population-based Helsinki Aging Study. Panoramic radiography supplemented by intraoral radiographs was performed on all these participants at the Institute of Dentistry, University of Helsinki, in 1990-1991. Follow-up radiographic examination was completed in 1995-1996. Mean number of teeth decreased during the follow-up period from 13.2 +/- 9.0 to 12.5 +/- 9.2 (P= 0.0001). Mean number of teeth with periapical lesions decreased in men from 1.3 +/- 1.4 to 0.6 +/- 0.9 (P = 0.007), but no differences in number of teeth with periapical findings were observed in women. There were relatively few changes in the subjects' radiographic periodontal findings. However, fewer teeth with vertical bone pockets >1-3 mm deep were found in the follow-up study than 5 years earlier (0.6 +/- 1.2 vs 1.1 +/- 1.8; P= 0.0008). In both the baseline and the follow-up studies the radiographic findings occurred in the subjects who had retained more natural teeth. In the follow-up study, 68% of the subjects had radiographically detected signs of chronic oral infection foci. It may be concluded that radiographically detected oral health parameters remain relatively unchanged, but treatment need is higher among those who have successfully retained their natural dentition into old age.

Aged↗

PubMed2004

Dose area product reference levels in dental panoramic radiology.

The purpose of this study was to measure DAP (Dose Area Product) values in panoramic radiology with the use of a DAP meter, to determine corresponding reference levels, and to compare DAP between panoramic and intraoral radiology. DAP was measured in 62 panoramic X-ray units for 3 types of exposure (male, female and child) and in 20 intraoral X-ray units of 50, 60 and 70 kVp. DAP reference levels were 117 mGy cm2, 97 mGy cm2 and 77 mGy cm2 for exposure of a male, female and child respectively. Results showed that DAP from a panoramic dental examination is approximately twice that from a single intraoral examination. DAP meter is a very convenient and easy to use tool for patient dosimetry and for the establishment of reference levels in dental panoramic radiology.

Adult↗

PubMed2003

Extraoral radiographic technique: an alternative approach.

The inability of certain patient populations to accept intraoral films and/or sensors can cause complications in the performance of endodontic therapy. An alternative technique (extraoral film placement) can be used to obtain clinically diagnostic radiographs. This article describes the alternative technique.

Adolescent↗

PubMed2006

Longitudinal study of periapical and endodontic status in a Danish population.

AIM: To describe and discuss changes in periapical and endodontic status in a general Danish population. METHODOLOGY: In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP). RESULTS: More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted. CONCLUSIONS: The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies.

Adult↗

PubMed2006

Endodontic status amongst 35-year-old Oslo citizens and changes over a 30-year period.

AIM: To determine the prevalence of apical periodontitis and quality of root fillings in 35-year-old citizens of Oslo, Norway in 2003, and to compare the results with data from the same age cohort collected by repetitive cross-sectional studies in 1973, 1984 and 1993. METHODOLOGY: A random sample of 250 35-year-old Oslo inhabitants was drawn from The National Bureau of Statistics Recordings. Attendance rate was 64%. Root filled teeth and teeth with periapical pathology were detected from panoramic radiographs and additional periapical radiographs of affected teeth were processed. The preriapical status was evaluated by applying the periapical index system (PAI). Chi-square and Student's t-tests were used for the evaluation of differences between the groups. RESULTS: Twenty-three per cent of the individuals examined had root filled teeth and 16% had at least one tooth with apical periodontitis. Root filled teeth were associated with PAI values of 1 and 2 (health) in 57% of cases. Prevalence of root filled teeth and apical periodontitis remained unchanged during the past 10 years. An increase in the proportion of root filled teeth with apical periodontitis from 18% in 1973 to 43% in 2003 was observed. CONCLUSIONS: Despite continuous improvement in dental health (reduced DMF-values) compared with the previous Oslo studies; there was no improvement in endodontic status from 1993 to 2003.

Adult↗

PubMed1992

Preservation of probing attachment and alveolar bone levels in 2 random population samples.

The present study is an attempt to elucidate the relation between ageing and loss of periodontal tissue support, by studying the occurrence of probing attachment and alveolar bone loss in two samples of randomly selected individuals. The 1st sample was recruited in Japan and comprised 319 subjects aged 20-79 years. The 2nd sample was recruited in Sweden and comprised 192 subjects aged 30-65 years. All individuals underwent a radiographic and a comprehensive clinical examination, including recordings of probing attachment level. Within the 2 samples, subsamples of individuals whose periodontal status indicated minimal experience of destructive periodontal disease were selected. In these particular subsamples, it was revealed that a substantial proportion of tooth surfaces, also in older subjects, remained with no attachment or alveolar bone loss. To a lesser extent, this could be also observed when the entire samples were analyzed, despite the presence of abundant plaque and gingival inflammation. The results indicated that intact supporting periodontal tissues can be retained in subjects of increased age and corroborate the suggestion that loss of clinical attachment and alveolar bone is not an obligatory consequence of ageing.

Adult↗

PubMed1987

Comparison of fibre optic transillumination with clinical and radiographic caries diagnosis.

Fibre optic transillumination (FOTI) has been employed during the course of a 3-yr clinical dentifrice trial which initially involved 3003 children. At the initial examination, a subgroup of 813 13-yr-olds, and at the following annual visit, 2247 14-yr-olds, were examined using a 150 W lamp and 0.5 mm diameter probe. Routine clinical and radiographic examinations were performed separately. Compared to the clinical scores for anterior teeth, FOTI detected an additional 64% of interproximal lesions at the first visit while, for the larger number of children at the second visit, the increase in lesion detection level using FOTI was 37%. For the posterior teeth the comparable figure at the second examination was 92%. When FOTI data were compared to radiographic data for more than 52,000 posterior interproximal surfaces, FOTI could only detect 17% of radiographic Grade 2 lesions and 48% Grade 3 lesions. Thus any assumption that FOTI diagnoses may be a substitute for bitewing radiography appears premature.

Adolescent↗

PubMed1995

Panoramic and restrictive intraoral radiography in comprehensive oral radiographic diagnosis.

It has been suggested that information from the panoramic radiograph makes it possible to appropriately select supplementary intraoral radiographs to achieve a comprehensive examination of teeth and surrounding bone with less patient dose but no significant information loss. Number of intraoral radiographs selected, information loss and monetary costs with such a procedure was evaluated in 40 patients. Results show that, on average, 5.1 intraoral radiographs were selected to supplement the panoramic radiograph. Of these, 3.1 contained information different from that in the panoramic radiograph but 2.0 did not. An additional 3.4 ought to have been taken to reach the result of the 'gold standard' achieved from a simultaneous evaluation by two expert observers of panoramic radiographs and full mouth surveys with intraoral radiographs. Sensitivity for the combined use of panoramic and supplementary intraoral radiographs was high (80-96%, depending on type of teeth) as regards periapical lesions and marginal bone loss but low for caries (42-96%). Specificity was high for periapical lesions and caries (95-97%) but low for marginal bone loss (50-92%). In Sweden, patient costs become almost the same for a combination of panoramic radiography and 8.5 intraoral radiographs as for a full mouth survey comprising 20 intraoral radiographs. The radiation dose reduction is 40-50% considering that the dose from a panoramic radiograph approximately corresponds to 2-4 intraoral radiographs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1998

Evidence for healing of interproximal intrabony defects after conventional and regenerative therapy: digital radiography and clinical measurements.

In 24 patients with advanced periodontitis 38 interproximal intrabony defects were treated by conventional surgery (C; n = 8) or guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (G; n = 17) or Polyglactin 910 barriers (V; n = 13). Presurgically (BL), 6 and 12 months postsurgically clinical parameters (GI, PII, PPD, PAL-V) and 36 standardized radiographs were obtained generating 72 pairs (36 BL/6 months; 36 BL/12 months). Using linear measurements on the radiographs and subtraction analysis, bony fill within the defects was assessed. Intrasurgically the extension of the intrabony defects was measured. Statistically significant (p < 0.05) attachment gain was found after 6 (C: 2.4 +/- 1.6 mm; G: 3.2 +/- 1.6 mm; V: 3.4 +/- 1.5 mm) and 12 months in all groups (C: 2.4 +/- 1.7 mm; G: 3.1 +/- 1.7 mm; V: 4.0 +/- 1.7 mm). Thirty-nine of 72 pairs of radiographs were unsuitable for subtraction analysis. Significant (p < 0.05) bony fill was observed at 6 (C: 0.3 +/- 1.0 mm; G: 0.7 +/- 1.2 mm; V: 0.9 +/- 1.2 mm) and 12 months (C: 0.0 +/- 1.1 mm; G: 1.4 +/- 1.5 mm; V: 1.5 +/- 1.7 mm) only after GTR surgery. GTR therapy yielded significantly more bony fill than conventional surgery 12 months postsurgically (p < 0.1). Bony fill (linear measurement) was influenced by age, smoking, baseline bone loss and PAL-V gain (p < 0.0001). Significantly more radiographs taken with potentially unstable support of the filmholder were not suitable for subtraction analysis than those with stable support (p < 0.05). Bony gain (subtraction analysis) was positively modulated by bony fill (linear measurement) and use of biodegradable barriers (p = 0.002). There is a correlation between PAL-V gain and bony fill (linear measurement). Smoking impairs attachment gain and bony fill. Potentially stable support of the filmholder provided radiographs suitable for subtraction analysis.

Adult↗

PubMed1998

Multiple supernumerary teeth. Case report.

The presence of supernumerary teeth, although not uncommon, occurs usually in the premaxillary region. Furthermore, examples of multiple supernumerary teeth in one patient are rare. A case involving the presence of multiple supernumerary teeth in all quadrants in described.

Adolescent↗

PubMed2002

Foreign bodies in the maxillary antrum: a case report.

A case is presented where six gutta percha (GP) points were introduced into the right maxillary antrum during routine endodontic treatment on an upper second premolar tooth in a poorly controlled insulin-dependent diabetic. The surgical management of the case is described and the possibly more serious sequelae are discussed. Comments are made on the appropriateness of the treatment plan.

Bicuspid↗