Detection of proximal caries using digital radiographic systems with different resolutions.

Background: Dental radiography is an important tool for detection of caries and digital radiography is the latest advancement in this regard. Spatial resolution is a characteristic of digital receptors used for describing the quality of images. Aim: This study was aimed to compare the diagnostic accuracy of two digital radiographic systems with three different resolutions for detection of noncavitated proximal caries. Settings and Design: Diagnostic accuracy. Materials and Methods: Seventy premolar teeth were mounted in 14 gypsum blocks. Digora® Optime and RVG Access were used for obtaining digital radiographs. Six observers evaluated the proximal surfaces in radiographs for each resolution in order to determine the depth of caries based on a 4‑point scale. The teeth were then histologically sectioned, and the results of histologic analysis were considered as the gold standard. Data were entered using SPSS version 18 software and the Kruskal–Wallis test was used for data analysis. P <0.05 was considered as statistically significant. Results: No significant difference was found between different resolutions for detection of proximal caries (P > 0.05). RVG access system had the highest specificity (87.7%) and Digora® Optime at high resolution had the lowest specificity (84.2%). Furthermore, Digora® Optime had higher sensitivity for detection of caries exceeding outer half of enamel. Judgment of oral radiologists for detection of the depth of caries had higher reliability than that of restorative dentistry specialists. Conclusion: The three resolutions of Digora® Optime and RVG access had similar accuracy in detection of noncavitated proximal caries.

Unusual Aggressive Radiographic Appearance of Simple Bone Cyst (A Case Report and Review of Literature).

Aim: This study reports a rare case of simple bone cyst (SBC) with a radiographic behavior similar to malignancies and a mixed internal structure in a 43 year-old woman who presented to a dental office with clinical symptoms. Presentation of Case: A 43 year-old woman presented to a dental office with chief complaint of pain at left mandibular molars for almost 2 months. She was wearing a cervical collar for some spine problems. The panoramic x-ray showed a radiolucent lesion with well defined non-corticated borders in periapical region of the mandibular left first molar (tooth 36). The tooth was vital. Cone Beam Computed Tomography (CBCT) images showed a lytic lesion with well defined noncorticated borders that destructs the lingual cortical wall without any sign of expansion to soft tissues. The upper border of the mandibular canal was unclear and seemed destructed by the lesion. The internal structure of the lesion seemed mixed. Three months later, the patient reported numbness of her lower lip. CBCT showed an enlargement of the lesion and the presence of buccal cortical perforation was seen. On biopsy the lesion was diagnosed as a Simple Bone Cyst (SBC). Discussion: SBC is often a benign lesion which appears as a radiolucent lesion with scalloped corticated borders. Adversely, current case showS a mixed lesion with buccal and lingual cortical perforation and rapid growth .the concomitant pain, the lower lip numbness and the radiographic appearance suggest the probability of an aggressive local condition or a malignancy Conclusion: SBC may have various radiographic presentations, unusual SBCs (or Traumatic bone cysts TBCs) may show aggressive radiographic characters. In these cases, biopsy and pathological features are necessary for diagnosis.