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PubMed2004

Comparison between subtraction radiography and conventional radiographic interpretation during long-term evaluation of periodontal therapy in Class II furcation defects.

BACKGROUND: Limited information comparing digital subtraction radiographic assessment with conventional radiographic interpretation is available from longitudinal clinical trials. The aim of this study was to evaluate the ability to detect periodontal bone changes during the long-term maintenance of Class II furcation defects by conventional radiographic interpretation compared to interpretation of digital subtraction images. METHODS: Standardized radiographs of 18 Class II furcation defects in mandibular molars were taken at baseline and at 6, 12, 18, and 24 months after non-resective periodontal surgery. Conventional radiographic and digital subtraction interpretations were performed masked, respectively, by two and three experienced examiners, according to the following categories: bone gain; bone loss; unchanged appearance; and impossible to visualize. Percent concordance and the kappa statistic value (kappa) were computed. RESULTS: Conventional radiographic and digital subtraction interpretation images resulted in 72 decisions for each examiner. The visual interpretation of digital subtraction images by two examiners revealed the same results. The interpretation of conventional radiographic images showed a low concordance between examiners (kappa < 0.40) at all examinations. The concordance between subtraction radiography and conventional radiographic interpretation was also low for all examiners (kappa < 0.36) at all examinations. Using subtraction radiography as a reference, bone changed and bone unchanged were diagnosed correctly in 47.2% of cases by examiner A, in 43.1% by examiner B, and in 38.9% by examiner C. CONCLUSION: It can be concluded that conventional radiographic interpretation is a more subjective and inaccurate method of detecting periodontal bone changes in Class II furcation defects in mandibular molars when compared with subtraction radiography.

Alveolar Bone Loss↗
PubMed2005

Compound composite odontome associated with an unerupted deciduous incisor--a rarity.

Odontomes are considered to be hamartomatous malformation rather than true neoplasm and are generally asymptomatic. Here is a case presentation of compound composite odontome with impacted deciduous teeth in an 11-year-old girl. A calcified mass was revealed in the radiograph and the case was finally diagnosed to be compound composite odontome. The mass was surgically excised.

Child↗
PubMed2005

Erupted maxillary conical mesiodens in deciduous dentition in a Bengali girl--a case report.

Mesiodens is a midline supernumerary tooth commonly seen in the maxillary arch. It is the most significant dental anomaly affecting permanent dentition mainly and primary dentition rarely. It may occur as an isolated dental anomalous condition or may be associated with a syndrome. Many theories have been promulgated to explain its etiology. But an exact etiology is still obscure. Incidence of mesiodens in children varies from 0.15 to 3.8%. Boys are affected more (2:1) than girls. Morphologically, mesiodens may be of three types: the most commonly seen is conical, while tuberculate and supplementary types.

Child, Preschool↗
PubMed2005

Premolarized double dens in dente in albinism--a case report.

Dens in dente are known to be associated with many dental abnormalities such as taurodontism microdontia, gemination, and dens evaginatus. This paper describes a rare case of double dens in dente in a lateral incisor with crown morphology similar to a premolar present in a patient with features of albinism. Problems associated with this condition and their management is discussed.

Adolescent↗
PubMed1999

Radiographic examinations as an aid to orthodontic diagnosis and treatment planning.

Seventy consecutive adolescents were examined to evaluate radiographic examinations as an aid to orthodontic diagnosis and treatment planning in combination with clinical examination. The clinical examination included dental impressions and extra- and intraoral photographs. The radiographic examination comprised a panoramic radiograph, a lateral cephalogram and six intraoral anterior periapical radiographs. Initially, only records from the clinical examination were used for diagnosis and treatment planning. If required, the dentist could choose any of the radiographs to accomplish the task. The number of radiographs ordered, the sequence of ordering and any change in diagnosis and treatment plan caused by the radiographs were registered. In 29% of the cases the initial diagnosis, based on the clinical examination, study models and photographs, coincided with the final diagnosis. In 93% of all cases the initial treatment plan coincided with the final one. Although the panoramic examination was the most common choice, it had only a minor effect on diagnostic and treatment decisions, while the cephalometric examination had a major impact on the diagnosis. In most cases the clinical examination, supplemented with study models and photographs, can provide adequate information for orthodontic treatment planning. The result stresses the importance of using individually based selection criteria for radiographic examination in order to prevent radiographs being obtained routinely.

Adolescent↗
PubMedDate not supplied

The radiographic assessment of implant patients: decision-making criteria.

Indications for the most frequently used imaging modalities in implant dentistry are proposed based on clinical need and biologic risk for the patient. To calculate the biologic risk, the authors carried out dose measurements. They demonstrated that the risk from a periapical radiograph is 20% of that from a panoramic radiograph. A panoramic radiograph and a series of 4 conventional tomographs of a single-tooth gap in the molar region carry 5% and 13% of the risk from computed tomography of the maxilla, respectively. Panoramic radiography is considered the standard radiographic examination for treatment planning of implant patients, because it imparts a low dose while giving the best radiographic survey. Periapical radiographs are used to elucidate details or to complete the findings obtained from the panoramic radiograph. Other radiographic methods, such as conventional film tomography or computed tomography, are applied only in special circumstances, film tomography being preferred for smaller regions of interest and computed tomography being justified for the complete maxilla or mandible when methods for dose reduction are followed. During follow-up, intraoral radiography is considered the standard radiographic examination, particularly for implants in the anterior region of the maxilla or for scientific studies. In patients requiring more than 5 periapical images, panoramic radiography is preferred.

Decision Making↗
PubMed2001

Periodontal conditions in 70-year-old women with osteoporosis.

The aim of the present study was to examine the periodontal conditions in an age cohort of 70-year-old women and compare an osteoporosis group with a control group with normal bone mineral density. 210 women 70 years old and randomly sampled from the population register of the community of Linköping were examined. Bone mineral density (BMD) of the hip was measured by dual energy X-ray absorptiometry. 19 women were diagnosed with osteoporosis (BMD below 0.640 g/cm2 in total hip). 15 of them accepted to participate in the study. As a control group 21 women with normal bone mineral density (BMD exceeding 0.881 g/cm2) were randomly selected from the initial population. The clinical examination included registration of the number of remaining teeth, dental plaque and periodontal conditions. The radiographic examination included a dental panorama and vertical bite-wing radiographs. The subjects also answered a questionnaire about their general health, age at menopause, concurrent medication, smoking and oral hygiene habits. The results from this study showed no statistically significant differences in gingival bleeding, probing pocket depths, gingival recession and marginal bone level between the women with osteoporosis and the women with normal bone mineral density. In conclusion, the present randomly selected and controlled study of osteoporotic and non-osteoporotic women, showed no statistically significant differences in periodontal conditions or marginal bone level. As periodontitis as well as osteoporosis are associated with age, our study of a well-defined age cohort is of interest, but the results should be interpreted with caution since the compared groups are small.

Absorptiometry, Photon↗
PubMed2001

Histologic evaluation of threaded HA-coated root-form implants after 3.5 to 11 years of function: a report of three cases.

This article presents a histologic evaluation of three hydroxyapatite (HA)-coated root-form implants retrieved from humans after being in function for 3.5 to 11 years. If the coronal portion, where bone loss was observed clinically and radiographically, is excluded, all implants appeared to be well osseointegrated, with intimate contact between the surrounding bone and the coating. There was no sign of resorption or dissolution of the HA coating. The coating had a uniform thickness (50 microm) equal to the thickness originally provided by the manufacturer In the few areas where there was no bone contact, the HA coating appeared to line the implant with no sign of dissolution. The few detached particles had tight contact with the bone, demonstrating the biocompatibility of the HA. The observations from the three reported cases suggest that the HA coating of dental implants may not be susceptible to resorption or dissolution under long-term function.

Adult↗
PubMedDate not supplied

Medicolegal aspects of altered sensation following implant placement in the mandible.

PURPOSE: Altered mandibular sensation following implant surgery may result in liability claims. Therefore the authors conducted a retrospective analysis of all liability claims related to persistent altered sensation following placement of mandibular implants reported to the Medical Consultants International (MCI) Company from 1992 to 1999. MATERIALS AND METHODS: Reports related to persistent altered mandibular sensation in 16 patients (12 women and 4 men) who underwent implant surgery in Israel were examined. The MCI files were retrospectively evaluated according to a structured form. The parameters studied included patient age and gender, implant location and length, imaging modality, and the time between actual damage and filing of a claim (ie, letter of demand or lawsuit). RESULTS: The time in months between actual damage and filing of claim ranged from 0 to 60 months (mean 21.5 months). No cases were found involving transient changes in sensation. The female/male ratio was 3:1. Implant length was equal to or longer than 13 mm in 6 of 7 implants placed in the molar region. In the premolar area, nerve injury was evident in 6 of 7 cases where implants shorter than 12 mm were used. CONCLUSIONS: Transient nerve injury rarely results in legal action. Maximum effort should be devoted to accurately determining the appropriate implant length in the mandible.

Adult↗
PubMedDate not supplied

Multi-rooted mandibular premolars: report of case.

Differential growth of the epithelial diaphragm is needed for the formation of multiple roots in the primary and permanent dentitions. In most instances, the mandibular premolars possess a single root. It is a very unusual event to find a case of bilateral multi-rooted first and second mandibular premolars. This paper presents such a case.

Bicuspid↗
PubMed2002

Digital subtraction radiographic analysis of GTR in human intrabony defects.

The relationship between radiographic crestal alveolar bone mass and changes in clinical periodontal attachment level following guided tissue regeneration (GTR) was evaluated in this retrospective study. A total of 12 intrabony two- or three-walled defects and 12 adjacent nondiseased proximal sites in 10 nonsmoking adult subjects received subgingival debridement and GTR using resorbable (Resolut; five sites) or nonresorbable (Gore-Tex; seven sites) barrier membranes. At a mean of 48.8 months posttreatment, clinical periodontal attachment level alterations were measured, and crestal alveolar bone mass changes on digital subtraction radiographic images derived from serial periapical radiographs were analyzed to correct for between-film geometric and contrast density differences. Intrabony defects exhibited a mean clinical periodontal attachment level gain of 2.3 +/- 0.4 mm, in contrast to a mean loss of 0.5 +/- 0.2 mm in adjacent nondiseased interproximal sites. Digital subtraction radiography revealed an increase in crestal alveolar bone mass at all intrabony sites treated with GTR and a decrease in three of the adjacent nondiseased sites. Site-based analysis yielded an odds ratio of 36 (P < .001) for the association between radiographic increases in crestal alveolar bone mass and clinical periodontal attachment level gains of > or = 2 mm. These results suggest a strong concordance between digital subtraction radiographic assessments of crestal alveolar bone mass and clinical periodontal attachment level in evaluating the long-term effects of GTR at human interproximal intrabony defects.

Absorbable Implants↗
PubMed2002

Bilateral maxillary fourth molars and a supernumerary tooth in maxillary canine region--a case report.

The occurrence of supernumerary teeth is a relatively uncommon dental anomaly. The aetiology is not clear. Supernumerary teeth have frequently been observed as solitary teeth and impacted in the maxillary arch. This case report describes the rare presence of bilateral maxillary fourth molars and a supernumerary tooth in the maxillary canine region. On the left side, the third molar was extracted first, allowing the fourth molar to move into a more favourable position for later extraction. Two-year postoperative radiography confirmed that the supernumerary tooth had migrated occlusally and mesially permitting a safer extraction procedure.

Adult↗
PubMed2002

Interpretation of dental and maxillofacial radiographs: a comparative study using an X-ray viewing box and window.

AIM: To ascertain if interpretation of radiographs by holding them up to a window rather than using a light viewing box has led to underdetection of clinically significant radiographic abnormalities. MATERIALS AND METHODS: Twenty members of staff were selected randomly. They were divided into two group i.e., ten house offers (Group 1), five specialist registrars and five demonstrators (Group 2). They interpreted 10 radiographs by first holding them up against a window, and then by using a light viewing box. A score out of 10 was obtained at each time (one for each film). RESULTS: A mean score of 6.6 (6 per cent) was obtained for Group 1 and a mean score of 8 (80 per cent) was obtained for Group 2 when radiographs were interpreted using a window. The mean score for both groups was 10 when a light viewing box was used. CONCLUSION: Important radiographic abnormalities went undetected when the light box was not used. Awareness should be raised among hospital staff with regard to the importance of using light viewing boxes for the interpretation of radiographs.

Dental Staff, Hospital↗