Clinical and radiographic evaluation of high viscosity bulk-fill resin composite restorations.

PURPOSE: To perform a clinical and radiographic evaluation comparing Filtek Bulk Fill high viscosity bulk-fill resins with Filtek Z350 XT nanoparticulate for 1 year. METHODS: 58 restorations were performed for each material (bulk-fill and nanoparticulate), for a total of 116 restorations. Among these, 42 Class I and 16 Class II restorations were performed for each group, in molars and premolars. Clinical evaluation was performed 7 days (baseline), 6 months and 1 year after restorations, using the World Dental Federation (FDI) criteria. Radiographs were obtained at 7 days and 1 year after the restoration was placed and the radiopacity was measured using Image J software at the same time interval. RESULTS: Of the 70 restorations available for evaluation at 1 year, the Mann-Whitney and Friedman tests showed no statistically significant difference for the FDI criteria analyzed. Greater radiopacity was observed for bulk-fill resin compared to nanoparticulate (two-way ANOVA, P= 0.022). This same test showed no difference in radiopacity between the groups in the two evaluation periods (P= 0.062). The high viscosity bulk-fill resin composite presented similar clinical performance to nanoparticulate resin in this evaluation period and higher radiopacity was observed for this material when compared to nanoparticulate resin, in both time periods. CLINICAL SIGNIFICANCE: The high viscosity bulk-fill resin composite showed similar performance to the nanoparticulate resin during the evaluation period of 1 year. Radiopacity showed high values for the bulk-fill resin when compared to nanoparticulate resin. The bulk-fill resin has potential to be used in posterior teeth.

Accuracy of Panoramic Radiography for Degenerative Changes of the Temporomandibular Joint.

BACKGROUND: Temporomandibular joint (TMJ) morphologies are complex, and changes in joint components have been studied extensively. TMJ conditions have many different etiologies, appearances, and relevant clinical significance. OBJECTIVE: The objective of this study was to evaluate the concordance of the diagnosis of degenerative changes in the TMJ in panoramic radiographs. MATERIALS AND METHODS: Cone beam computed tomography (CBCT) was used as a reference standard. Images of 84 patients (168 TMJs), 61 females (72.6%) and 23 males (27.4%) with an average age of 47.4 years, were evaluated by three radiologists who established the presence or absence of degenerative changes in the jaw heads. The data were collected and organized in a spreadsheet. Concordance between evaluators was analyzed using agreement percentages, statistical κ, and confidence intervals. In the analysis of compliance with CBCT, sensitivity, specificity, predictive positive and negative values, and probabilities of false positives and negatives were also calculated. All inferential tests were performed with a 5% significance level. RESULTS: The percentage of agreement among raters in panoramic radiographs ranged from 66.7% to 82.9%, considered mild to moderate. Correlation between radiographic and tomographic images ranged from 45.5% to 64.9% in the inter-evaluator reviews, representing a very mild agreement. Sensitivity ranged from 28.6% to 58.7% and specificity from 66.7% to 100.0%. Positive predictive value ranged from 77.1% to 100.0%; the negative predictive value was lower, ranging from 32.2% to 54.8%. The probability of false negatives was higher than that of false positives, ranging from 45.2% to 67.8%. CONCLUSION: The rater did not reach acceptable diagnosis levels.

Effect of Pseudocolor Filter in Micro-computed Tomography Images for Detection of Proximal and Occlusal Caries Lesions in Primary Molars.

AIM: This study aimed to evaluate the effect of pseudocolor filter in micro-computed tomography (CT) images for the detection of proximal and occlusal caries lesions in primary molars. MATERIALS AND METHODS: For this in vitro analysis, 26 extracted human primary teeth were scanned using a compact micro-CT device (Skyscan 1172, Bruker micro-CT, Kontich, Belgium) and the projection images were reconstructed into cross-sectional slices (NRecon v.1.6.9, Bruker micro-CT, Kontich, Belgium). The original and pseudocolor images were evaluated twice by three calibrated radiologists. The tooth surfaces were scored according to Mejàre et al. criteria. The agreement was assessed by the Kappa coefficient, and the Chi-square test was used to evaluate the association between radiolucent lesion depth in enamel and dentin. RESULTS: There was a good intra-observer agreement for detecting proximal caries lesions with or without using pseudocolor filter (k >0.60). The inter-examiner agreement had similar results, and the agreement rates were good or moderate for the proximal surfaces. There were no statistically significant differences between the original and pseudocolor images (p >0.05). The pseudocolor filter showed high sensitivity and specificity when compared with the original image with the exception of the occlusal face in enamel. CONCLUSION: The pseudocolor filter appears to be a promising enhancement tool for micro-CT images used for the detection of caries lesions in primary molars; even if it was not significantly different from the original images. CLINICAL SIGNIFICANCE: The pseudocolor filter converts grey scale images into color images. It is present in micro-CT software and must increase the diagnostic capacity of detecting caries lesion in occlusal and proximal surfaces.