PURPOSE: The purpose of this study was to evaluate the in vitro validity of quantitative light-induced fluorescence-digital (QLF-D) and laser fluorescence (DIAGNOdent) for assessing proximal caries in extracted premolars, using digital radiography as reference method. MATERIALS AND METHODS: A total of 102 extracted premolars with similar lengths and shapes were used. A single operator conducted all the examinations using three different detection methods (bitewing radiography, QLF-D, and DIAGNOdent). The bitewing x-ray scale, QLF-D fluorescence loss (ΔF), and DIAGNOdent peak readings were compared and statistically analyzed. RESULTS: Each method showed an excellent reliability. The correlation coefficient between bitewing radiography and QLF-D, DIAGNOdent were −0.644 and 0.448, respectively, while the value between QLF-D and DIAGNOdent was −0.382. The kappa statistics for bitewing radiography and QLF-D had a higher diagnosis consensus than those for bitewing radiography and DIAGNOdent. The QLF-D was moderately to highly accurate (AUC = 0.753 – 0.908), while DIAGNOdent was moderately to less accurate (AUC = 0.622 – 0.784). All detection methods showed statistically significant correlation and high correlation between the bitewing radiography and QLF-D. CONCLUSION: QLF-D was found to be a valid and reliable alternative diagnostic method to digital bitewing radiography for in vitro detection of proximal caries.
Bicuspid ; Consensus ; Diagnosis ; Fluorescence* ; In Vitro Techniques ; Methods ; Radiographic Image Enhancement ; Radiography ; Radiography, Bitewing ; Reading

With the development of medical radiography, cone beam computed tomography (CBCT) has been widely used in stomatology because of its numerous advantages, such as adequate spatial resolution, low radiation, undistorted three- dimensional tissue information, and good applicability for hard tissue imaging. Traditional periapical radiography is based on two-dimensional image which displays the three-dimensional object and its surrounding structures. Periapical radiography can only show the overlapping mesio-distally direction bone destruction, can't show buccolingual direction bone destruction. As a kind of three-dimensional imaging technology, CBCT can show three-dimensional structure of the organization from sagittal, coronal and axial direction, to overcome the defect of two-dimensional image such as overlap and deformation. CBCT has a unique advantage than periapical radiography in the diagnosis and treatment for periapical disease. This review will summarize the difference between CBCT and periapical radiography in the periapical disease.
Cone-Beam Computed Tomography ; Humans ; Imaging, Three-Dimensional ; Periapical Diseases ; diagnostic imaging ; Radiography, Bitewing

PURPOSE: The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. MATERIALS AND METHODS: One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve (Az) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). RESULTS: The mean Az values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest Az value. CONCLUSION: Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.
Bicuspid ; Cone-Beam Computed Tomography ; Dental Caries ; Humans ; Molar ; Radiography, Bitewing ; ROC Curve ; Steel ; Tooth

PURPOSE: This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. METHODS: Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. RESULTS: This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. CONCLUSIONS: Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.
Alveolar Bone Loss ; Bicuspid* ; Cheek ; Mandible ; Maxilla ; Radiography, Bitewing ; Reproducibility of Results

OBJECTIVE: To evaluate the practical value of nearinfrared light transillumination (NILT, DIAGNOcam) on detection of incipient proximal caries in primary molars. METHODS: In this study, 4-9-year-old children with suspicious proximal lesions in primary molars were recruited. The target teeth were examined with clinical examination, bitewing radiograph and DIAGNOcam. And the caries indexes were rated as 0 (no caries), 1 (caries reaching outer 1/2 enamel), 2 (caries reaching inner 1/2 enamel), and 3 (dentine caries). Those primary molars with at least one of the adjacent molars according with the criteria of invasive treatment, i.e. the teeth were diagnosed as caries reaching inner 1/2 enamel or dentine with at least two detection methods, were included. The target teeth with caries index ≥2 accepted the invasive treatment. And the caries status of the adjacent teeth was observed under direct vision and those teeth of caries index ≥2 would also accept the invasive treatment. The relationship of lesions to enamel-dentine junction (EDJ) were recorded and used as reference standard to compare the sensitivity, specificity and accuracy of those three methods in detecting the incipient proximal caries in primary molars. RESULTS: In this study, 36 children with 104 suspicious proximal lesions in primary molars were recruited, of which 5 were diagnosed as no caries, 20 were diagnosed as superficial enamel caries, and 79 accepted invasive treatment, of which 22 were diagnosed as EDJ caries, and 57 as dentine caries. The sensitivity of clinical examination, bitewing radiograph, and DIAGNOcam were 68.69%, 81.82%, 78.79%, respectively. The specificity were 100.00%, 100.00%, 80.00%, and the accuracy were 75.96%, 85.65%, 78.85%, respectively. As for superficial enamel caries, the sensitivity of clinical examination was lowest, only 10%, while DIAGNOcam was 60%, higher than 40% of bitewing radiograph. As for EDJ caries, the sensitivity of bitewing radiograph was highest as 86.36%, followed by DIAGNOcam 72.73% and clinical examination 68.18%. As for dentine caries, the sensitivity of the three detection methods were higher than 85%, of which bitewing radiograph was the highest as 94.74%. CONCLUSION The accuracy of DIAGNOcam in detecting incipient proximal caries in primary molars was comparable to that of bitewing radiograph. It was safe, and convenient with no exposure to radiation, which was applicable to be used in pediatric dentistry.
Child ; Child, Preschool ; Dental Caries ; Dentin ; Humans ; Molar ; Radiography, Bitewing ; Reproducibility of Results ; Tooth, Deciduous ; Transillumination

OBJECTIVETo establish and evaluate a computer-based software system (caries diagnosing system, CDS): CDS for better detection of initial approximal caries based on the performance of radiography.

METHODSA total of 190 approximal surfaces from 95 extracted posterior teeth were examined by bite-wing radiography. After analysing and extracting the approximal lesion's characteristics of X-ray performance, using Matlab and VC language, the CDS was established. Then the proximal surfaces of these teeth were detected automatically by CDS, and scored by naked eyes of 8 experienced dentists for the extent of lesions. The histological appearance of sectioned teeth was used as the gold standard to assess sensitivity, specificity, accuracy, and reproducibility.

RESULTSThe sensitivity of CDS was 0.728, Pearson's correlation was 0.722, better than that of optic estimation. The reproducibility of CDS was good too.

CONCLUSIONSThe CDS can report the lesion site and extension, its diagnostic level is better than that of optic estimation, it is an reasonably sensitive and accurate method for the detection of initial approximal caries in present clinic practice, and a tool of providing objective data.

Automatic Data Processing ; Dental Caries ; diagnostic imaging ; Humans ; In Vitro Techniques ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Radiography, Bitewing ; methods ; Software

OBJECTIVETo study the risk factors of alveolar bone loss (ABL) of primary teeth in Chinese children.

METHODSCaries, restoration, food impact, pulp pathosis, calculus, and periodontal status were examined in 106 children aged 3-10 years old. Bite-wing radiographs of posterior teeth were scanned into computer. The distance from the cemento-enamel junction to alveolar bone crest was measured from the mesial surface of the first primary molar to the distal surface of the second primary molar using Adobe Photoshop 5.0 image analyzing system. ABL was recorded if the distance was more than 2 mm and the lamina dura was absent. All patients were divided into ABL group and non-ABL group. All data were analyzed by SPSS 10.0.

RESULTSAlveolar bone loss was found in 31 children (29%). Most of the affected areas were located at the proximal surface of primary molars. The mean of dmft and proximal dmft in ABL group were higher than those in non-ABL group (P < 0.01). Logistic regression also confirmed that proximal caries was high related factor. Inadequate restoration, and pulp pathosis were also related to alveolar bone loss in primary tooth.

CONCLUSIONIn children, alveolar bone loss was mainly associated with local factors such as proximal caries, inadequate restoration, and pulp pathosis. Caries and pulp pathosis might be treated in time. Children with bone loss should be re-examined regularly.

Alveolar Bone Loss ; Alveolar Process ; Child ; Dental Caries ; Dental Pulp ; Female ; Humans ; Male ; Molar ; Radiography, Bitewing ; Risk Factors ; Tooth, Deciduous

This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan's radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography-which provides precise three-dimensional information-was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomography.
Adult ; Cone-Beam Computed Tomography ; methods ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Fused Teeth ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; methods ; Molar, Third ; abnormalities ; diagnostic imaging ; Patient Care Planning ; Radiography, Bitewing ; Radiography, Panoramic ; Tooth Root ; abnormalities ; diagnostic imaging ; Tooth, Impacted ; diagnostic imaging ; Tooth, Supernumerary ; diagnostic imaging

Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
Calcium Compounds ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Microsurgery ; instrumentation ; Middle Aged ; Periapical Diseases ; therapy ; Periapical Tissue ; diagnostic imaging ; physiology ; Radiography, Bitewing ; Regeneration ; physiology ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Ultrasonic Surgical Procedures ; instrumentation ; Wound Healing ; physiology