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PubMedDate not supplied

Visual-tactile examination compared with conventional radiography, digital radiography, and Diagnodent in the diagnosis of occlusal occult caries in extracted premolars.

PURPOSE: This laboratory study compared visual-tactile examination with conventional radiographs, digital radiographs, and laser fluorescence in the detection of occlusal occult caries on extracted premolar teeth. METHODS: Extracted premolars without obvious caries or restorations were collected from school dental clinics. Occlusal surfaces of 320 extracted premolars were examined visually with an explorer, then examined using the KaVo Diagnodent unit and scored using specific criteria. The teeth were exposed using conventional and digital radiography, respectively. The radiographs were assessed for dentin radiolucencies beneath the occlusal surface. RESULTS: Of the 320 teeth used in this study, 302 were scored as sound by visual-tactile examination. Of these, 57 (19%) demonstrated dentin radiolucency on conventional bite-wings, and 245 (81%) were scored as radiographically sound. Thus, the sensitivity and specificity values of the visual-tactile examination compared with conventional radiography were 81% and 44%, respectively. In contrast, Diagnodent produced results of 82% sensitivity and 36% specificity when compared with conventional radiography. When compared to digital radiography, the sensitivity and specificity values of the visual-tactile examination were 90% and 44%, respectively. In contrast, when compared to digital radiography, Diagnodent showed a very low specificity of only 32%, although sensitivity was still high at 91%. Differences in specificity among the techniques were statistically significant (P < .03), whereas differences in sensitivity were not (P > .01). CONCLUSIONS: Although the diagnosis of occult dentinal caries may be further enhanced by the Diagnodent, a combination of visual-tactile examination and either conventional or digital radiography should identify over 80% of lesions.

Adolescent↗
PubMed2004

Reduction of absorbed doses to the thyroid gland in orthodontic treatment planning by reducing the area of irradiation.

The objectives were to study whether a smaller area of irradiation resulted in a significant reduction in the dose of absorbed radiation to the thyroid gland for three radiographic modalities commonly used in cephalometric treatment planning. The aim of this research, was to study the effect of the field size on the absorbed dose of radiation to the thyroid gland, as measured with thermoluminescent dosimeters (TLD) in a phantom. Three radiographic modalities were used: panoramic, cephalometric, and intra-oral. For each modality, a large and a small collimator were used. A Rando Alderson phantom comprising a natural human cranium and cervical vertebrae embedded in a thermoplastic material simulating human soft tissue was used to measure absorbed dose to the thyroid gland. These measurements were made using lithium fluoride (LiF) TLDs. A significant reduction in absorbed dose to the thyroid gland was obtained by reducing the collimator in all three modalities. A 15% reduction in absorbed dose to the thyroid gland was achieved for the combination of small field sizes compared to the combination of large field sizes. Combining the use of selection criteria together with a smaller field of irradiation than normally used made a reduction in absorbed dose to the thyroid gland of around 30% possible.

Cephalometry↗
PubMed2004

In vivo validity and reliability of IR fluorescence measurements for caries detection and quantification.

Studies of detection and quantification of dental caries by KaVo DIAGNOdent have shown high diagnostic accuracy and high inter-operator agreement in vitro. The aim of the present study was to determine whether comparable results could be achieved under clinical conditions. In Part I (occlusal surfaces), 52 occlusal sites (suspected caries) were examined by visual inspection, bitewing radiography, and two DIAGNOdent devices. The fissures were then opened, and lesion depth established according to a four point scale. In Part II (smooth surfaces), two operators performed DIAGNOdent measurements of incipient carious lesions on the buccal surface of 30 molar teeth. The readings were compared with corresponding measurements by Quantitative Light-induced Fluorescence (deltaF). The results for occlusal surfaces disclosed very low correlation between lesion depth and readings by the two DIAGNOdent devices. The intra-operator agreements were very good (0.80-0.92), and the inter-operator agreement was good (0.71-0.87). A significant systematic difference in readings by the two devices precludes general recommendations of cut-off levels. However, individually suitable cut-off values for dentinal lesions gave good qualitative information about the surface (77%-85% over all correct observations), rather than quantitative information in terms of lesion depth within the dentine. In this context, the DIAGNOdent device might be of help for the clinician in the process of decision making about invasive therapy. For smooth surfaces, the correlation between readings obtained with the DIAGNOdent device and deltaF were acceptable (0.57-0.73). The intra-operator agreement was 0.94 for both operators (excellent), and the inter-operator agreement ranged from 0.79 to 0.87 (very good).

Adolescent↗
PubMedDate not supplied

Florid cemento-osseous dysplasia.

Cemento-osseous dysplasia is probably the most common fibro-osseous lesion encountered in clinical practice. It is thought to be a reactive phenomenon that arises from elements within the periodontal ligament. Here we present a case of 37-year-old female patient, who reported for a regular dental check-up. Incidentally, mixed radiopaque-radiolucent lesions were found bilaterally in the radiograph. Based on the clinical examination and radiographic evaluation, we arrived at a diagnosis of florid cemento-osseous dysplasia.

Adult↗
PubMedDate not supplied

Conventional dental radiology: what the general radiologist needs to know.

This article aims to provide an overview of intraoral and orthopantomographic radiographs, including technique, indications, artefacts, relevant anatomy, current notation and common dental pathology. The normal anatomy is emphasised, because it is required for effective radiographic interpretation. Dental pathology, i.e. caries, periodontal disease, periapical inflammatory lesions and dental anomalies are illustrated.

Artifacts↗
PubMed2006

Current practice in conventional and digital intraoral radiography: problems and solutions.

In summary, it can be said for digital radiography that digital exposures can be taken just as well as dental film exposures. The problems found when using holders for the paralleling technique are similar in conventional and digital radiography. Good intraoral x-ray images can be produced as a rule with practice, good will and a skilful hand. The bisected angle technique should no longer be used, as this no longer corresponds to the state of the art and of dental medicine. It is therefore important that all intraoral dental exposures are taken with corresponding holders and the paralleling technique. Thus, the bite wing and measuring exposures are no longer taken with the finger or other aids, but suitable holders are used. However, being able to place the film, the storage phosphor or the sensor in the oral cavity correctly is just as important as the choice of exposure technique. Theoretical knowledge and practical skill are therefore closely related.

Equipment Design↗
PubMed2006

The prevalence of dental caries in 5 - 18-year-old insulin-dependent diabetics of Fars Province, southern Iran.

BACKGROUND: The association of dental caries and diabetes mellitus has not received enough attention, in spite of the fact that both diseases are associated with the ingestion of dietary carbohydrates. This study was undertaken in Fars Province, southern Iran, to determine the prevalence rates of dental caries in a group of metabolically well-controlled patients with type I diabetes mellitus and in a control group. METHODS: Fifty patients (22 boys and 28 girls) with type I diabetes mellitus under follow-up of the Endocrinology and Metabolism Research Center of Shiraz University of Medical Sciences, with a mean +/- SD age of 11.72 +/- 3.36 years and mean +/- SD fasting blood sugar of 235.74 +/- 103.61 mg/dL, entered this study. A similar study was conducted to determine the prevalence of dental caries in 12-year-old school children in Shiraz, Iran who served as the control group. After completing a questionnaire, the patients were examined separately by two dentists. Before the clinical examination, bitewing radiographies were performed. Student's t- and Chi-square tests were used for statistical analysis in relation to sex, age of onset of diabetes mellitus, socioeconomic and nutritional status, family history of diabetes mellitus, and orohygiene status. RESULTS: The mean +/- SD DMFT for diabetic children was 9.64 +/- 4.64 (decayed = 8.12 +/- 3.90, missing = 0.62 +/- 1.34, and filling = 0.90 +/- 2.10). The lower permanent first molars were the most frequency decayed and the incisors were the healthiest teeth. DMFT score and the frequency of decayed teeth were higher in boys than in girls. However, the rate of filling and missing teeth were higher in girls. DMFT and the number of decayed teeth were higher in patients with poor oral hygiene. The number of healthy first permanent molars was much higher in the mixed dentition groups than in those with permanent teeth. A direct correlation was found between the health status of the first permanent molar tooth and having type I diabetes mellitus. CONCLUSION: Oral hygiene was somewhat poorer in diabetic patients than in the control group. Regular dental check-ups for preventive measures such as fluoride therapy, fissure sealant, regular medical follow-ups for proper control of metabolic abnormalities to decrease occurrence of xerostomia, omission of cariogenic substances from dietary regimen, fluoridation of drinking water, and individual and group education of diabetic patients regarding proper dental hygiene are recommended.

Adolescent↗
PubMed2006

Clinical evaluation of diagnodent in detection of occlusal caries in children.

The aim of this in vivo study was to evaluate the effectiveness of DIAGNOdent, visual and radiographic examination in detecting non-invasive diagnosis of occlusal caries in children. In this study, 92 untreated molars with sound occlusal surface or enamel and/or dentin caries were selected from 28 healthy patients, aged 7-17 years. All teeth were examined by two researchers using each of three diagnostic system (DIAGNOdent, visual, radiographic). Interpretation of the DIAGNOdent value and the radiolucency on the bitewing film were combined with the visual examination to decide where the teeth had to be opened. Depth of caries was recorded. Sensitivities and specificities were calculated for each diagnostic method using the biopsy scores as gold standard. Intra- and inter-examiner reproducibility for each method was assessed by calculating Cohen's kappa. The kappa value of inter-examiner reproducibilty was highest for visual examination (0.935), and lowest for DIAGNOdent measurements (0.698). Intra-examiner reproducibilty of DIAGNOdent mesurements was also good (0.745 and 0.665). Sensitivity and specificity for DIAGNOdent, visual examination and bitewing radiography were 0.86/0.80, 0.69/1.00 and 0.36/1.00, respectively. It was concluded that Diagnodent with a high sensitivity may be useful adjunct to visual examination with a high specificity in detecting occlusal caries.

Adolescent↗
PubMed2006

Radiographs associated with one episode of orthodontic therapy.

Obtaining lifetime diagnostic radiation histories in head and neck cancer studies is often challenging due to the almost universal lack of centralized registries on X-ray utilization in medicine and dentistry. Both the common nature of orthodontics and the young age at which orthodontics typically occurs make it important to quantify what diagnostic radiographs are typically taken during orthodontic therapy. The aim of this study was to assess the number and type of radiographic films associated with one episode of orthodontic therapy in an educational setting. Charts stored in an orthodontic clinic at one academic setting were randomly sampled, and the type and number of radiographic examinations were tallied for the 325 individuals who were in orthodontic therapy for at least one year. Being under orthodontic therapy for one or more years was associated with a median number of seven extra-oral radiographs and twenty-four intra-oral radiographic films. The extra-oral radiographs included three panoramic radiographs and three cephalometric radiographs. Less than 10 percent of the variability was explained by factors such as age, gender, calendar year, surgical orthodontic therapy, and duration of therapy. Head and neck cancer etiology studies should take into account the ionizing radiation during episodes of orthodontic care. The substantial variability in radiographic practices in orthodontics could be reduced by research into clinical utility and by establishing guidelines.

Adolescent↗
PubMedDate not supplied

[Study of caries using axial-mesial-distal sections and interproximal and periapical radiographs with paralleling and bisecting technics].

The authors, considering the radiographic complementary survey importance in Operative Dentistry, has made an analysis on the three main radiologic technics (Bite-Wing and Bisecting Angle and Paralleling Technic), in an attempt to compare the per cent magnification grade of the carious lesion radiographic image, by measurements taken at the tooth sections, and over the patient's radiographs, to contribute with a more accurate diagnosis performed by the dentist.

Bicuspid↗
PubMed1989

The problem of occlusal caries and its current management.

Occlusal caries has become relatively more important, due to the changing pattern of dental caries that has occurred in the developed countries of the world. Accurate diagnosis of the activity of a carious lesion is important, because arrest and remineralization are possible. Diagnosis of occlusal caries is difficult due to the morphology of the occlusal surface. Unfortunately, topical action of fluorides is thought to be making diagnosis increasingly difficult. The literature suggests that we should be examining for caries under good lighting and a dry field, the use of a blunt probe being reserved for gently removing debris from fissures to enable good visualisation. Bitewing radiography is valuable in the detection of occlusal as well as approximal caries, but good radiographic technique and careful viewing are essential. Electronic caries detection may well prove useful in the future. The traditional restorative approach to occlusal caries resulted in inconsistent treatment decisions, poor durability of restorations, and the unfortunate consequences of replacement restorations. It seems logical to take a more conservative, preventive approach in the management of dental caries. Fissure sealants should be used preventively for the caries-prone patient, and therapeutically for the suspect or early carious lesion. Where the caries has spread into dentine, as shown radiographically, then the sealant restoration may be more suitable. These techniques have been shown to be safe and effective, although careful case selection, appropriate manipulation of materials, recall, and maintenance are essential to long-term success.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Caries↗
PubMed1993

Trends in the prescription of radiographs for comprehensive care patients in U.S. and Canadian dental schools.

Results of this 1992 survey are compared to results from 1977 and 1987 surveys to establish long-term trends in radiographic prescribing practices for dentulous adult comprehensive care patients in U.S. and Canadian dental schools. The major trends include a decline in prescribing both an intraoral full-mouth series and panoramic radiograph (46 percent to 19 percent to 9 percent of schools from 1977 to 1987 to 1992, respectively). These changes were complemented by an increase in prescribing a full-mouth series only (32 percent to 48 percent to 57 percent, respectively), and an increase in the use of selection criteria (2 percent to 19 percent to 26 percent, respectively). Between 1987 and 1992 there was little change in the preferred examination for the edentulous adult patient, and small changes in the preferred examination for the child patient.

Adult↗
PubMed1993

Ontario dentists: 3. Radiographs prescribed in general practice.

In February 1991, a mail survey was used to poll a sample consisting of about 10 per cent of Ontario's general dentists. The data obtained provided information about the radiographs prescribed by dentists for five different patient types, which were described to the respondents. The per cent agreement between the radiographic procedures prescribed by Ontario dentists and the ADA-approved Center for Devices and Radiological Health (CDRH) guidelines ranged from three per cent to 79 per cent, depending on patient type and disease risk. For each patient and risk type, there was considerable variation in the radiographs prescribed.

Adult↗