In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth.

OBJECTIVE: The purpose of this in vivo study was to confirm the detection of proximal caries using near-infrared light transillumination (NILTI) (DIAGNOcam) device, and to compare the diagnostic performance of the device with other caries detection methods, including visual examination using the International Caries Detection and Assessment System (ICDAS), bitewing radiography (BW), an LED-based device (Midwest Caries I.D.), and a laser fluorescence device (LFpen). METHODS: A total of 974 proximal surface of permanent posterior teeth from 34 patients (19 females and 15 males between the ages of 22-55) were evaluated in the present study. After clinical examination of each proximal surface by an experienced examiner, they were coded according to the ICDAS criteria and subsequently with BW, the NILTI, LED, and LFpen. The proximal dentin caries of 106 were opened based on the combination of visual, NILTI and radiographic assessment and validated; and were treated with restorative materials. The data were analyzed with descriptive statistics and calculation of the sensitivity, specificity, and area under curve (AUC). RESULTS: The highest sensitivity values were recorded from NILTI readings (99.1%), followed by BW scores (86.8%). The highest specificity values were recorded from ICDAS (100%). The best AUC values were found from the NILTI readings (0.97), followed by BW (0.93) and ICDAS (0.87). CONCLUSION: The NILTI device exhibited the best performance in terms of detecting proximal dentin caries.

Evaluation of dehiscence and fenestration in adolescents affected by bilateral cleft lip and palate using cone-beam computed tomography.

INTRODUCTION: We evaluated the dehiscence and fenestration presence in maxillary and mandibular anterior teeth of patients affected by bilateral cleft lip and palate (BCLP) and compared the findings with a well-matched control group of noncleft patients using cone-beam computed tomography. METHODS: Cone-beam computed tomography images of 51 patients were divided into 2 groups (group 1, 21 patients affected by BCLP; mean age; 14.62 ± 2.89 years; and group 2, 30 patients as the noncleft control group; mean age, 14.22 ± 1.05 years) and assessed them for dehiscence and fenestration in the anterior maxillary and mandibular teeth. Data were analyzed with the Student t test, Pearson chi-square test, and Fischer exact test. RESULTS: The prevalences of dehiscence in patients affected by BCLP were 61.11% in the maxillary and 48.41% in the mandibular anterior teeth, whereas the rates in the noncleft group were 7.78% and 16.67%, respectively (P < 0.001). The presence of fenestration was found to be statistically significantly higher in the maxillary central incisors of the BCLP group compared with the noncleft controls (P < 0.05), and almost similar rates were noted for the other teeth, with no statistically significant differences (P > 0.05). CONCLUSIONS: Our data suggest that patients affected by BCLP may have higher prevalences of dehiscence in the maxillary and mandibular anterior teeth and of fenestration in the maxillary central incisors.

The effects of different restorative materials on the detection of approximal caries in cone-beam computed tomography scans with and without metal artifact reduction mode.

OBJECTIVES: The aim of this study was to investigate the influence of artifacts produced by different restorative materials on the detection of approximal caries in cone-beam computed tomography (CBCT) scans with and without the application of an artifact-reduction (AR) option. STUDY DESIGN: Ninety-eight noncavitated premolar and molar teeth were placed with approximal contacts consisting of 2 sound or carious teeth and 1 mesial-occlusal-distal restored tooth with resin-modified glass-ionomer cement (RMGIC), amalgam, composite, ceramic-based composite (CBC), or computer-aided design-computer-aided manufacturing (CAD-CAM) zirconia materials in between. The teeth were scanned with a CBCT system with and without the AR option. Images were evaluated by 2 observers. The teeth were histologically evaluated, and sensitivity, specificity, and areas under the receiver operating characteristic (ROC) curve were calculated according to the appropriate threshold. RESULTS: Specificity and sensitivity values for contact surfaces ranged from 0-48.39 and 82.93-98.40, respectively. The AR option affected (P < .05) approximal caries detection of the amalgam, composite, CAD-CAM, and CBC groups in contact surfaces and composite and RMGIC groups in noncontact surfaces. CONCLUSION: Artifacts produced by different restorative materials could affect approximal caries detection in CBCT scans. Use of the AR option with CBCT scans increases the accuracy of approximal caries detection.

Florid cemento-osseous dysplasia: A rare case report evaluated with cone-beam computed tomography.

A 29-year-old systemically healthy female patient presented to our department. Cone-beam computed tomographic images showed multiple well-defined sclerotic masses with radiolucent border in both right and left molar regions of the mandible. These sclerotic masses were surrounded by a thin radiolucent border. We diagnosed the present pathology as florid cemento-osseous dysplasia and decided to follow the patient without taking biopsy. For the patient, who did not have any clinical complaints, radiographic followupis recommended twice a year. The responsibility of the dentist is to ensure the follow-up of the diagnosed patients and take necessary measures for preventing the infections.

Effects of voxel size and resolution on the accuracy of endodontic length measurement using cone beam computed tomography.

An accurate determination of the working length is indispensable for successful endodontic treatment. The aim of this study was to determine the influence of the voxel size and resolution of CBCT on measuring root canal working length. Thirty extracted single-rooted permanent teeth were used for this study. The working lengths of the teeth were determined by a researcher inserted a K-file into each canal until the tip became visible through the major foramen. The file was withdrawn until its tip was seen at the level of the coronal-most border of the major foramen under. The rubber stop was adjusted to the occlusal reference and the distance from the stop to the false tip was measured with digital calipers and recorded as the actual working length. The CBCT images were obtained with a Planmeca ProMax 3D Mid (Planmeca, Helsinki, Finland) using four sets of settings: from voxel size 0.5mm to voxel size 1.0mm. These measurements were compared with actual lengths (as a control group) using Analysis of Variance and the Dunnett Post Hoc Test. The Pearson correlation coefficient (r) and 95% confidence intervals were calculated to compare all measurement methods. The significance level was set at P<0.05. No significant difference was found among CBCT groups and working length. A highest correlation was found between the actual length and smallest voxel size and highest CBCT measurements (r=0.94). CBCT imaging can be used endodontic working length measurement and the smallest voxel size and highest resolution yielded more accurate results.

Comparison of different caries detectors for approximal caries detection.

BACKGROUND/PURPOSE: Detection of approximal caries may be difficult using conventional methods including visual inspection (VI) and radiography. The purpose of this in vitro research was to evaluate the efficiency of light-emitting diode (LED) and laser fluorescence (LF) devices, and radiographic and visual examination in approximal caries diagnosis. MATERIALS AND METHODS: One hundred and fifty-six approximal regions were evaluated. All approximal regions were investigated using LED and LF tools after radiography and VI were performed. Histological evaluation of teeth was performed using stereomicroscopy. The area under the receiver operating characteristic curve and accuracy, specificity, sensitivity values calculated regarding approximal caries diagnose. RESULTS: The specificity of the bitewing examination was higher for both T1 and T2 thresholds (0.97 and 0.99, respectively), and the LF device showed better sensitivity at each threshold compared with the other devices used for caries diagnosis (0.94 at T1 and 0.79 at T2). The receiver operating characteristic curves presented that the LF device was more successful than the other techniques at T1 threshold and VI was better than the other caries detection methods at T2 threshold. The kappa values for interobserver agreements were 0.43 (LF pen), 0.33 (LED device), 0.55 (VI), and 0.75 (bitewing examination). CONCLUSION: The ability of bitewing radiography to identify sound surfaces was better than that of the other methods. The LF device was the most sensitive tool for detecting approximal surfaces with caries, followed by the LED device.

Relationship between CBCT and panoramic images of the morphology and angulation of the posterior mandibular jaw bone.

PURPOSE: We determined actual bucco-lingual angulation values and morphological variations of residual bone in the mandibular posterior edentulous region using cone-beam computed tomography (CBCT) and panoramic radiography. A second aim was to investigate whether it was possible to predict bone morphology from panoramic radiographs. METHODS: Data were collected from 77 consecutive patients referred for both CBCT and panoramic radiography in our department. Two-dimensional and three-dimensional images of the probable implant placement region were investigated. The bucco-lingual angulation values and crest type were determined directly from the cross-sectional images of the posterior edentulous region. The edentulous region was divided into three groups: second premolar, first molar, or second molar region. The observations were evaluated by the computer software, SPSS 22.0 (SPSS Inc. Chicago, USA). The crest type was classified into three groups: type U, type C, or type P. Kappa statistics, Kolmogorov-Smirnov tests, ANOVA, and Kruskal-Wallis tests were used in statistical analyses. The significance level was set at p < 0.05. RESULTS: Type C was more frequent in the second premolar region and the crest type had changed to type U in the second molar region. The predictability of the type U was highest in the second molar region. Moderate agreement was found in the predictability of type U in the molars (κ = 0.602). The mean value of bucco-lingual angulation was highest in the second molar region, followed by the first molar region. There were statistically significant differences between the bucco-lingual angulation of the crest types in the second premolar and first molar regions (p < 0.05). CONCLUSIONS: Bucco-lingual angulation values and morphology change through the posterior mandible. Type U was predicted at a higher rate in the second molar region from panoramic radiographs. These results demonstrate predicting high-risk areas in the posterior mandible for implant therapy from panoramic radiography.

Comparison of the delay in processing time and protective plastic cases in two phosphor plate systems.

OBJECTIVE: The purpose of this study was to analyze two phosphor plate systems (PSPs) (Dürr Dental, Digora Optime) according to their scanning delay and protective plastic case performances. METHODS: Two PSPs using an aluminum step wedge were exposed. These plates were placed in three different protective plastic cases (manufacturers' original cases, black case, and white case) before obtaining the radiographs and were then processed immediately and 1, 5, 10, 30, 60, 120, 240, and 480 min after exposure. Mean gray values (MGVs) of the 3rd, 5th, 7th, and 9th steps of the wedges were compared using ANOVA. RESULTS: Statistically significant differences were found between the two PSPs (P < 0.001). ANOVA revealed that the MGVs of four steps of the wedges were significantly different from each other for all scan delays (P < 0.001). MGVs increased with increasing scanning delay, except the group with Dürr plates in their original cases. Reduction in image quality began 5 min after exposure in the other Dürr plate groups. CONCLUSIONS: Within the limitations of the current study, it can be concluded that scanning delay causes a reduction in image quality, and using the manufacturer's original protective case will result in better performance of PSPs.

A novel LED-based device for occlusal caries detection.

The aim of this in-vitro study was to compare the performance of laser-based (DIAGNOdent, KaVo, Biberach, Germany) and LED-based (Midwest Caries I.D., DENTSPLY Professional, New York, USA) caries detectors in the detection of occlusal caries in permanent molars. The study consisted of 129 visually sound or non-cavitated pits or fissures in 82 extracted permanent human molar teeth. Two trained examiners used the laser-based and LED-based caries detectors to examine the fissures for caries. The teeth were then sectioned at the surfaces suspected of containing occlusal caries and histologically evaluated using stereomicroscopy as a gold standard. Inter-examiner reliability of the caries detector examination was assessed using Cohen's Kappa statistics. The sensitivity, specificity, and accuracy in diagnosing occlusal caries using the two devices were calculated according to appropriate cut-off scores. Receiver operating characteristic (ROC) curves were also determined to compare the diagnostic performance of the devices in occlusal caries diagnosis. The cut-off level of significance was taken as p = 0.005. Cohen's Kappa showed substantial agreement for the laser-based caries detector (0.74), and almost perfect agreement for the LED-based (0.89) caries detector. The specificity of the laser-based device varied from 0.49 to 0.97 at T1 and T2. Its sensitivity varied from 0.33 to 0.65 at T1 and T2. The specificity of the LED-based device varied from 0.48 to 0.56 at T1 and T2. Its sensitivity varied from 0.65 to 0.84 at T1 and from 0.80 to 0.84 at T2. Taking the limitations of the current study into consideration, the DIAGNOdent laser pen was more accurate in determining when teeth were free of occlusal caries than was the Midwest Caries I.D. LED-based device, although the Midwest Caries I.D. device more often revealed the presence of occlusal caries than did the DIAGNOdent pen.

An evaluation of factors associated with persistent primary teeth.

The aim of the present study was to investigate the reasons for the persistence of primary teeth and also use panoramic radiography to determine the characteristics of persistence teeth. Four-hundred and twenty-six panoramic radiographies, which diagnosed one or more retained primary teeth, were selected from 100,577 panoramic radiographic image files from nine clinics and six different cities in Turkey. The selected radiographies were evaluated to determine the reasons for the persistence of primary teeth; furthermore, this study analyzed the characteristics of the retained primary teeth including tooth type, number, location, and root resorption, and whether, or not, the primary teeth showed evidence of pathological conditions, such as periodontal problems, caries, ankylosis, infra-occlusions, or tipping of the adjacent permanent teeth. Six hundred and seventy-seven retained primary teeth were determined in 426 patients (148 males and 278 females). Retained primary teeth were found most frequently in the mandible rather than the maxilla and the left side was more frequently affected than the right side. Level 1 was found as a most frequently encountered root resorption level. Within the limitation of the present study, the most common type of persistent primary teeth seen on the dental arch were mandibular primary second molars, followed by maxillary primary canines. The most frequent reason for the persistence was the congenital absence of successors to the primary teeth, followed by impaction of the successor teeth.

Does the panoramic radiography have the power to identify the gonial angle in orthodontics?

PURPOSE: The objective of this study was to assess gonial angle under the angle classification by comparing panoramic radiograph and lateral cephalometric radiograph. MATERIALS AND METHODS: 49 patients (25 males, 24 females) with an age range of 12-29 years participated in the present study. Subjects were retrospectively selected among those categorised as skeletal and dental Class I, II, and III malocclusion group. Using lateral cephalometric radiograph, mandibular and ramal planes were drawn and based on these planes. Gonial angle was determined from two tangents which were drawn from the inferior border of the mandible and posterior borders of the condyle and ramus of both sides in the panoramic radiographs. Multiple comparison tests (ANOVA) were used to determine differences between the three angle groups. RESULTS: There were no significant differences between Class I, II, and III malocclusion group values of gonial angles determined by lateral cephalometric radiograph and panoramic radiographs (P > 0.05). CONCLUSION: Panoramic radiograph results were shown to be as reliable as lateral cephalometric radiograph in all angle classifications. Panoramic radiography can be used as an alternative radiographic technique to detect gonial angle in orthodontic patients.