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Talachi F, Abesi F, Ezoji F, Mahjoub S, Ghorbani H, Bijani A. Comparison of accuracy cone-beam computed tomography and digital bitewing radiography for detection of recurrent caries under various restorative materials: in vitro study. Oral Radiol 2023; 39:722-730. [PMID: 37335388 DOI: 10.1007/s11282-023-00690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE The aim of this study was to compare and evaluate diagnostic accuracy of two different CBCT scan modes and digital bitewing radiography for detection of recurrent caries under five different restorative materials, and determine the relationship between the types of restorative materials. MATERIALS AND METHODS In this in vitro study, 200 caries-free upper and lower premolars and molars were selected. A standard deep Class II cavities was created in the middle of the mesial surface of all teeth. In 100 teeth of the experimental and control groups, secondary caries was artificially demineralized. All teeth were filled with five types of restorative material including two types of conventional composite resins, flow composite resin, glass ionomer and amalgam. The teeth were imaged with high resolution (HIRes) and standard CBCT scan modes and digital bitewing. The AUC, sensitivity, specificity and areas under the ROC curve were calculated and verified through SPSS. RESULTS CBCT technique was the best option in diagnosing recurrent caries. The diagnostic accuracy and specificity of HIRes CBCT scan mode was significantly higher than standard mode (P = 0.031) and bitewing (P = 0.029) for detection of recurrent caries, especially under composite group. There were no significant differences in accuracy value of bitewing and standard CBCT scan mode. CONCLUSION CBCT showed higher accuracy and specificity on the detection of recurrent caries which was more accurate than bitewing radiography. The HIRes CBCT scan mode achieved the highest accuracy and performed the best in recurrent caries detection.
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Affiliation(s)
| | - Farida Abesi
- Dental Materials Research Center, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Fariba Ezoji
- Department of Restorative Dentistry, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Soleiman Mahjoub
- Department of Clinical Biochemistry, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hakimeh Ghorbani
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Mosavat F, Ahmadi E, Amirfarhangi S, Rafeie N. Evaluation of diagnostic accuracy of CBCT and intraoral radiography for proximal caries detection in the presence of different dental restoration materials. BMC Oral Health 2023; 23:419. [PMID: 37353807 PMCID: PMC10290356 DOI: 10.1186/s12903-023-02954-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 04/07/2023] [Indexed: 06/25/2023] Open
Abstract
PURPOSE This study aimed to assess the diagnostic accuracy of cone-beam computed tomography (CBCT) and digital intraoral radiography for the detection of proximal caries adjacent to amalgam, e.max porcelain, and metal-ceramic restorations (MCRs). MATERIALS AND METHODS Parallel intraoral radiographs were obtained from 40 posterior teeth using PSP sensors. To obtain CBCT scans, the teeth were first radiographed alone, and were then positioned next to a tooth with an amalgam restoration, MCR, and e.max porcelain crown, and radiographed again. Two blinded observers scored radiographs using a four-point scale (0: absence of proximal caries, 1: enamel caries, 2: carious lesion extending to the outer half of dentin, 3: carious lesion extending to the inner half of dentin). Tooth sections were made, and the grade of caries was determined under a light microscope at x12 magnification. The sensitivity, specificity, and accuracy of CBCT and intraoral radiographs were then calculated. RESULTS Artifact-free CBCT scans and intraoral radiographs had the highest diagnostic accuracy (0.826 and 0.657, respectively) while CBCT images of the teeth next to the amalgam restorations (0.526) had the lowest accuracy. The diagnostic accuracy of CBCT images of the teeth next to the porcelain crowns and MCRs was 0.613 and 0.601, respectively. CONCLUSION Artifact-free CBCT images had higher diagnostic accuracy than intraoral radiography for the detection of all grades of proximal caries. The diagnostic accuracy of CBCT images of teeth adjacent to amalgam, porcelain, and MCRs was lower compared to intraoral radiographs and artifact-free CBCT images.
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Affiliation(s)
- Farzaneh Mosavat
- Oral and Maxillofacial Radiology Department, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - Elham Ahmadi
- Department of Operative Dentistry, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Amirfarhangi
- Department of Prosthodontics, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Niyousha Rafeie
- Dental Research center, Dentistry research institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Ruiz DC, Farias-Gomes A, Fontenele RC, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ, Groppo FC. Influence of extensive use of a photostimulable phosphor receptor on the diagnosis of proximal carious lesions: An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:539-547. [PMID: 36566136 DOI: 10.1016/j.oooo.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of the extensive use of a photostimulable phosphor (PSP) receptor on the diagnosis of proximal carious lesions. STUDY DESIGN Forty posterior teeth were paired and mounted in 20 phantoms. Using a PSP receptor of the Express intraoral system, 1 radiograph of each phantom was acquired, totaling 20 radiographs (group 1). After 400 acquisitions, another radiograph of each phantom was obtained, totaling 20 new radiographs (group 2). This procedure was also done after 800 (group 3), 1,200 (group 4), and 1,600 (group 5) acquisitions, resulting in 100 radiographs. Another 40 radiographs (20 phantoms × 2 groups) were obtained with a second PSP sensor to evaluate the diagnostic replicability of the receptors. All 140 radiographs were assessed independently by 5 examiners for the presence of proximal caries. Area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared among the groups by analysis of variance. The Student t test evaluated the diagnostic replicability of the receptors. The significance level was set at 5% (P < .05). RESULTS The diagnostic outcomes for proximal caries did not differ among the groups (P ≥ .37). The diagnostic values did not differ among the radiographs acquired with the 2 PSP receptors (P ≥ .75). CONCLUSIONS The diagnosis of proximal carious lesions was not affected by extensive use of the PSP receptor.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Hugo Gaêta-Araujo
- School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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The impact of digital filters on the diagnosis of simulated root resorptions in digital radiographic systems. Clin Oral Investig 2022; 26:4743-4752. [PMID: 35267096 DOI: 10.1007/s00784-022-04438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the influence of digital filters of intraoral radiographic systems on the diagnosis of simulated internal and external root resorptions and image quality. MATERIALS AND METHODS Internal root resorption (IRR) and external root resorption (ERR) were simulated in 34 teeth. For image acquisition, two radiographic systems were used: Digora Toto and VistaScan. All filters available in these systems were applied. Three observers scored the detection of root resorptions in a 5-point scale. The noise and the contrast-to-noise ratio (CNR) were calculated. The area under ROC curve, sensitivity, specificity, and accuracy were obtained. One-way ANOVA with Tukey's post hoc tests compared the diagnostic values, noise, and CNR between the filters (α = 0.05). RESULTS For ERR, there were no significant differences in diagnostic values between the filters tested for both systems. For IRR, Original and Noise Reduction filters presented higher sensitivity than the Sharpen2 filter for images from Digora Toto, with no differences between the other groups. For VistaScan, there were no significant differences of diagnostic values between the groups studied. Noise values differed among the filters of both systems. The CNR of the filters differed only for the bone region for Digora Toto, while for VistaScan, both tooth and bone regions differed. CONCLUSIONS Despite promoting changes in pixel intensities and affecting the noise level of the radiographic images, the digital filters of Digora Toto and VistaScan systems do not affect the diagnosis of internal or external root resorptions. CLINICAL RELEVANCE Digital filters are common tools in digital radiographic systems and may be used by the professional without impairment in root resorptions diagnosis.
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da Silveira Tiecher PF, Assein Arús N, Adams Hilgert E, Dias da Silveira HE, Pante Fontana M, Dias da Silveira HL, Vizzotto MB. Exploring digital filters for internal root resorption: how can we improve the diagnosis of small lesions? Dentomaxillofac Radiol 2021; 51:20210314. [PMID: 34767483 PMCID: PMC9499201 DOI: 10.1259/dmfr.20210314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the impact of enhancement filters in detecting small simulated internal root resorptions (IRR). METHODS: Forty-two extracted human teeth were sectioned, connected, and stored in a dry human jaw and X-rayed with photostimulable phosphor plates (PSPs), composing the control group (CG). In the middle-third of the root canals, IRR lesions were simulated using Da Silveira protocol. Later, the specimens were X-rayed to create the test group (TG). All images acquired were exported with seven enhancement filters plus the original image. Three examiners used a five-point Likert scale to evaluate the images regarding the presence/absence of IRR. Diagnostic efficacy was assessed from sensitivity and specificity results. Comparison among filters was performed by using receiver operating characteristic (ROC) curve analysis. RESULTS: Moderate values of Kappa interexaminer (0.403-0.620) and high values of Kappa intraexaminer (0.757-0.915) were observed. The best performance occurred in the CG (p < 0.05). Original images presented the greatest sensitivity and area under the ROC curve (0.595-0.750), while the Endo filter presented the greatest specificity (0.952). Inversion and Pseudo-3D images produced the greatest doubt in the diagnosis, significant for CG with the Pseudo-3D filter (p < 0.05). CONCLUSIONS: The Original and 'Endo' filters should be chosen as it offers greater diagnostic ability and allows more confidence during the evaluation.
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Affiliation(s)
| | - Nádia Assein Arús
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduarda Adams Hilgert
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Heloisa Emilia Dias da Silveira
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Heraldo Luís Dias da Silveira
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana Boessio Vizzotto
- Department of Surgery and Orthopedics, Oral Radiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Abu El-Ela WH, Farid MM, Abou El-Fotouh M. The impact of different dental restorations on detection of proximal caries by cone beam computed tomography. Clin Oral Investig 2021; 26:2413-2420. [PMID: 34601634 DOI: 10.1007/s00784-021-04207-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the effects of different types of restorations on observer ability to detect proximal caries in CBCT images. MATERIALS AND METHODS Forty human premolars and molars with artificial proximal caries were placed proximal and distal to 5 molars having different restorations (amalgam, composite, resin-modified glass ionomer cement (RMGIC) fillings, zirconia, and lithium disilicate crowns) and a non-restored molar. CBCT scans were obtained using i-CAT® Next Generation. Images were rated twice by 2 observers. The exact depth of artificial caries was histologically established. Sensitivity, specificity, and area under the receiver operating characteristic curve (Az) values were calculated. RESULTS Caries detection in teeth surfaces mesial and distal to amalgam showed compromised specificity and accuracy. Moreover, caries detection in teeth surfaces mesial to zirconia crown showed low sensitivity, specificity, and accuracy. Capability of CBCT in detection of proximal caries in teeth adjacent to composite, RMGIC, and lithium disilicate was comparable to those adjacent to non-restored molar. CONCLUSIONS CBCT scans performed for tasks other than caries detection should be assessed for proximal caries in absence of any restorations as well as in presence of composite, RMGIC fillings, and lithium disilicate crowns. However, CBCT should not be used for proximal caries detection in teeth adjacent to amalgam and teeth surfaces mesial to zirconia crowns. CLINICAL SIGNIFICANCE It is important to investigate the influence of artifacts produced by various restorations on CBCT-based caries detection to optimize CBCT benefits, caries diagnosis and avoid unnecessary treatment of sound surfaces.
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Affiliation(s)
- Walaa Hussein Abu El-Ela
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt.
| | - Mary Medhat Farid
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
| | - Mona Abou El-Fotouh
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
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Şeker O, Kamburoğlu K, Şahin C, Eratam N, Çakmak EE, Sönmez G, Özen D. In vitro comparison of high-definition US, CBCT and periapical radiography in the diagnosis of proximal and recurrent caries. Dentomaxillofac Radiol 2021; 50:20210026. [PMID: 33979235 DOI: 10.1259/dmfr.20210026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the in vitro performance of high-definition (HD) US, CBCT and periapical radiography for the visibility of proximal and recurrent caries in teeth with and without restoration. METHODS A total of 240 molar teeth were divided into eight groups each comprised of 30 teeth. Control groups consisted of teeth without caries (Group 1-4; N = 120), whereas diseased groups consisted of teeth with proximal caries (Group 5-8; N = 120 teeth). Finally, a total of four image sets were obtained as follows: i) PSP periapical radiography, ii) CBCT 0.075 mm voxel size, iii) CBCT 0.2 mm voxel size and iv) HD US images. The image sets were viewed separately by four observers by using a 5-point confidence scale. Intraclass correlation coefficients were calculated. The areas under the ROC curves were compared using chi-square tests. Significance level was set at α = 0.05. RESULTS Intraobserver agreement for both readings for the four observers ranged between 0.848 and 0.988 for CBCT (0.075 mm) images; 0.658 and 0.952 for CBCT (0.2 mm) images; 0.555 and 0.810 for periapical images; 0.427 and 0.676 for US images. Highest AUC values were found for CBCT (0.075 mm) images and lowest for US images. Statistically significant differences were found among CBCT (0.075 mm) images and US images (p < 0.001), CBCT (0.2 mm) images and US images (p < 0.001) and periapical images and US images (p < 0.001) for the detection of proximal caries. CONCLUSION Periapical and CBCT images outperformed HD US imaging in the detection of proximal dental caries.
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Affiliation(s)
- Oya Şeker
- Restorative Dentistry Department, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Cihan Şahin
- Restorative Dentistry Department, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Dentistomo Private Diagnostic Imaging Center, Ankara, Turkey
| | - Doğukan Özen
- Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
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Buchanan A, Hancock R, Kalathingal S. The role of software in quality assurance for indirect digital intraoral imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:313-321. [DOI: 10.1016/j.oooo.2020.03.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 03/05/2020] [Accepted: 03/14/2020] [Indexed: 11/24/2022]
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Detection of Simulated Periapical Lesion in Intraoral Digital Radiography with Different Brightness and Contrast. Eur Endod J 2019; 4:133-138. [PMID: 32161900 PMCID: PMC7006595 DOI: 10.14744/eej.2019.46036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/17/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: To assess the detection of simulated periapical lesions in digital intraoral radiography with different levels of brightness and contrast combinations, and to investigate the observers’ preference of image quality for this diagnostic task. Methods: Digital radiographs were acquired prior to periapical lesion simulation and after each one of four defects enlargement. Original images were adjusted in 4 brightness and contrast combinations. Five observers evaluated the images according to the presence of periapical lesion on a 5-point scale. In a second moment, the observers ordinated the images subjectively, according to quality, from the best to the worst to detect the bone defect. The area under the receiver operating characteristic curve was calculated for the diagnostic values and compared by two-way ANOVA. The significance level was set at 5% (P<0.05). Results: No differences were found between the diagnostic values of the five combinations of brightness and contrast (P>0.05). The overall results showed low values of area under the Receiver Operating Characteristic (ROC) curve and sensitivity of the periapical radiography in the detection of periapical lesions of sizes from 1 to 3, which rose substantially in size 4. For image quality, combinations with the lowest brightness and highest contrast were preferred by the observers in 58% of the cases. Conclusion: Brightness and contrast adjustments do not influence the detection of simulated periapical lesions in digital intraoral radiography. Lower brightness and higher contrast images were preferred for this diagnostic task.
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Abdinian M, Ghaiour M. Effect of Filtration and Slice Thickness of Cone-Beam Computed Tomography Images on Occlusal Caries Detection: An Ex Vivo Study. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2018; 15:283-293. [PMID: 30833974 PMCID: PMC6397738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 07/11/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the diagnostic accuracy of different filtrations and slice thicknesses of cone-beam computed tomography (CBCT) in the detection of occlusal caries. MATERIALS AND METHODS One-hundred teeth were selected for this ex-vivo experimental study. The CBCT images of the teeth were evaluated and scored by two observers in panoramic and cross-sectional views using different slice thicknesses and filtrations. Paired t-test, repeated-measures analysis of variance (ANOVA), and the least significant difference (LSD) test were used to compare the data with the histological gold standard. Receiver operating characteristic (ROC) analysis was used to determine the diagnostic accuracy of each slice thickness and filtration (P<0.05). RESULTS The mean score of true caries detection in cross-sectional views was lower than that in panoramic views (P<0.05). Repeated-measures ANOVA showed a significant difference in the mean of true detections in different thicknesses of cross-sectional views, but this difference was significant only between 5 mm thickness and other thicknesses in panoramic views. On all the views, increasing the thickness decreased the accuracy of caries detection. Repeated-measures ANOVA showed a significant difference between different filtrations; on all the views, increasing the filtration increased the accuracy of caries detection. CONCLUSIONS An increase of filtration of CBCT images increases the accuracy of occlusal caries detection; however, an increase in slice thickness results in a lower diagnostic accuracy.
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Affiliation(s)
- Mehrdad Abdinian
- Associate Professor, Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Ghaiour
- Postgraduate Student, Department of Pediatric Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Francio LA, Silva FE, Valerio CS, Cardoso CAEA, Jansen WC, Manzi FR. Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth. Imaging Sci Dent 2018; 48:87-96. [PMID: 29963479 PMCID: PMC6015931 DOI: 10.5624/isd.2018.48.2.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/26/2018] [Accepted: 03/14/2018] [Indexed: 12/31/2022] Open
Abstract
Purpose The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations (P>.05), but showed no discriminatory ability for amalgam restorations (P<.05). Conclusion Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.
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Affiliation(s)
| | | | - Claudia Scigliano Valerio
- Department of Oral Radiology, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Flávio Ricardo Manzi
- Department of Oral Radiology, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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Shokri A, Kasraei S, Lari S, Mahmoodzadeh M, Khaleghi A, Musavi S, Akheshteh V. Efficacy of denoising and enhancement filters for detection of approximal and occlusal caries on digital intraoral radiographs. J Conserv Dent 2018; 21:162-168. [PMID: 29674818 PMCID: PMC5890406 DOI: 10.4103/jcd.jcd_213_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background and Objectives Image processing and enhancement filters can significantly improve the diagnostic value of digital radiographs. Evidence shows that increasing the contrast and filtering improve the diagnostic accuracy for caries detection. This study sought to assess the diagnostic accuracy of original and enhanced digital radiographs for the detection of approximal and occlusal caries. Subjects and Methods In this experimental study, incipient carious lesions were artificially created on 120 proximal and occlusal surfaces of human extracted permanent molar and premolar teeth. After mounting the teeth in wax, digital radiographs were obtained using photostimulable phosphor plates and enhanced by enhancement filters 1, 2, and 3 with/without denoising. Two oral and maxillofacial radiologists blinded to filtering viewed the radiographs and filled out a chart. A definite diagnosis was made by a pathologist by observing the samples under a stereomicroscope (gold standard). Data were analyzed using SPSS software version 16. Interobserver agreement was calculated using kappa statistics. Chi-square test was used to assess the correlation between qualitative variables. Results Assessment of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value showed that enhancement filter 2 without denoising was the most efficient and original radiographs (filter free) were the least efficient radiographs for the detection of carious and sound surfaces. Application of filters significantly increased the accuracy of caries detection on digital radiographs. The lowest diagnostic accuracy was noted for the detection of enamel lesions on original radiographs (52%). Enhancement filter 2 plus denoising was the best filter for the detection of these lesions (79.25%). No significant difference was noted among different filters for detection of carious and sound surfaces but enhanced, and original radiographs were significantly different in visualization and detection of caries (P < 0.05). Conclusion Application of enhancement filters, particularly enhancement filter 2 with/without denoising, increases the accuracy of caries detection on digital radiographs.
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Affiliation(s)
- Abbas Shokri
- Department of Oral and Maxillofacial Radiology, Dental Implant Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahin Kasraei
- Department of Restorative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Lari
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Mahmoodzadeh
- Department of Orthodontics, Dental Implant Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Khaleghi
- Department of Orthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Musavi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Akheshteh
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
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Sousa Melo SL, Belem MDF, Prieto LT, Tabchoury CPM, Haiter-Neto F. Comparison of cone beam computed tomography and digital intraoral radiography performance in the detection of artificially induced recurrent caries-like lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:306-314. [PMID: 28690085 DOI: 10.1016/j.oooo.2017.05.469] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/06/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to compare the performance of cone beam computed tomography (CBCT) and digital radiography in the detection of artificial recurrent caries-like lesions under amalgam and composite fillings. STUDY DESIGN The study included class II cavities in 30 molars that had been filled with amalgam. Fifteen of those molars had the restoration-enamel interface artificially demineralized. Phantoms were prepared, and CBCT images were acquired with 2 units in 3 voxel sizes (K9000, 0.076 mm; i-CAT, 0.2 mm and 0.4 mm). Intraoral radiographs were obtained with 3 systems (Digora, VistaScan, and RVG-6100). Amalgam fillings were then replaced by composite, and new images were obtained. Three examiners assessed all of the images. Sensitivity, specificity, accuracy, and receiver operating characteristic curve were calculated and verified through analysis of variance and the Tukey test. RESULTS There were no significant differences in sensitivity and specificity when the same restorative material was present or when the restorative materials were compared with the imaging technique as a constant. As for accuracy and receiver operating characteristic curve, there were statistically significant differences when the 2 materials were compared, and there were differences in the amalgam group when the imaging modalities were compared. CONCLUSIONS CBCT performed similarly to intraoral radiography in detecting demineralization under restorations. However, the voxel size and the type of restorative material influenced its performance.
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Affiliation(s)
- Saulo Leonardo Sousa Melo
- Clinical Assistant Professor, Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
| | - Manuella Dias Furtado Belem
- Research Scholar, Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lucia Trazzi Prieto
- Research Scholar, Department of Operative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Cinthia Pereira Machado Tabchoury
- Associate Professor, Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Professor, Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Abdinian M, Nazeri R, Ghaiour M. Effect of Filtration and Thickness of Cross-Sections of Cone Beam Computed Tomography Images on Detection of Proximal Caries. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2017; 14:223-230. [PMID: 29285032 PMCID: PMC5745226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES When a patient has cone beam computed tomography (CBCT) images based on the treatment plan, it is possible to use these images for evaluation of caries, and there is no need for new radiographs, according to the "as low as reasonably achievable" (ALARA) principle. The aim of this study was to determine the effect of filtration and thickness of CBCT cross-sections on detection of proximal caries. MATERIALS AND METHODS In this in-vitro study, 100 teeth were placed in the dental sockets of a dry skull, and were fixed in normal proximal contacts. CBCT images were taken and were evaluated by two observers on the panoramic view at 1-, 3- and 5-mm-thick cross-sections, with the use of filtrations 0, 1 and 2. Afterwards, the samples were sectioned and underwent a histological evaluation. McNemar's test was used to compare the findings on CBCT images and histological evaluation. Receiver operating characteristic (ROC) curves and logistic regression were used to evaluate the diagnostic accuracy of different cross-sections. RESULTS The maximum AZ-value was achieved at 3-mm thickness/filtration 2. However, the differences between 1-mm thickness/filtration 2 and 1-mm thickness/filtration 1 were not significant (P=0.728 and 0.868, respectively). The minimum AZ-value was achieved at 5-mm thickness/filtration 0. CONCLUSIONS Although CBCT is not sufficiently effective in detecting caries, the best cross-sections for detection of proximal caries were achieved at 3-mm thickness/filtration 2, 1-mm thickness/filtration 2 and 1-mm thickness/filtration 1.
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Affiliation(s)
- Mehrdad Abdinian
- Assistant Professor, Dental Implants Research Center, Department of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahman Nazeri
- Postgraduate Student, Department of Research, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Ghaiour
- Postgraduate Student, Department of Pediatric Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Impact of cone-beam computed tomography scan mode on the diagnostic yield of chemically simulated external root resorption. Am J Orthod Dentofacial Orthop 2017; 151:1073-1082. [PMID: 28554453 DOI: 10.1016/j.ajodo.2016.10.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this in-vitro study was to evaluate the influence of cone-beam computed tomography scans on the diagnosis of chemically simulated external root resorption. METHODS One hundred extracted anterior teeth were selected. Subsurface demineralization was induced on a limited area of the apical third of the root of 49 teeth. Each tooth was placed in an empty socket of a partially edentulous dry mandible. Cone-beam computed tomography images were obtained according to 3 protocols: (1) half scan, 0.40-mm voxel size; (2) full scan, 0.40-mm voxel size; and (3) full scan, 0.125-mm voxel size. Three observers evaluated the images. Sensitivity, specificity, accuracy, and area under the curve were compared with the Cochran Q and Mann-Whitney U tests. RESULTS Protocol 3 had the highest sensitivity (81.63%), accuracy (80.67%), and area under the curve (0.807). There were statistically significant differences between protocol 3 and the other 2 protocols (P <0.001). The specificity of protocol 1 (84.97%) was greater than that of protocols 2 (69.93%) and 3 (79.74%); however, a statistically significant difference was found only between protocols 1 and 2 (P = 0.005). CONCLUSIONS A more dedicated, high-resolution scan should be acquired when one intends to investigate the early stage of external root resorption during orthodontic treatment. However, this does not imply that all orthodontic patients should be subjected to high-dose cone-beam computed tomography scans.
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Shahidi S, Zadeh NK, Sharafeddin F, Shahab S, Bahrampour E, Hamedani S. An in vitro comparison of diagnostic accuracy of cone beam computed tomography and phosphor storage plate to detect simulated occlusal secondary caries under amalgam restoration. Dent Res J (Isfahan) 2015; 12:161-6. [PMID: 25878682 PMCID: PMC4387629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND This study was aimed to compare the diagnostic accuracy and feasibility of cone beam computed tomography (CBCT) with phosphor storage plate (PSP) in detection of simulated occlusal secondary caries. MATERIALS AND METHODS In this in vitro descriptive-comparative study, a total of 80 slots of class I cavities were prepared on 80 extracted human premolars. Then, 40 teeth were randomly selected out of this sample and artificial carious lesions were created on these teeth by a round diamond bur no. 1/2. All 80 teeth were restored with amalgam fillings and radiographs were taken, both with PSP system and CBCT. All images were evaluated by three calibrated observers. The area under the receiver operating characteristic curve was used to compare the diagnostic accuracy of two systems. SPSS (SPSS Inc., Chicago, IL, USA) was adopted for statistical analysis. The difference between Az value of bitewing and CBCT methods were compared by pairwise comparison method. The inter- and intra-operator agreement was assessed by kappa analysis (P < 0.05). RESULTS The mean Az value for bitewings and CBCT was 0.903 and 0.994, respectively. Significant differences were found between PSP and CBCT (P = 0.010). The kappa value for inter-observer agreement was 0.68 and 0.76 for PSP and CBCT, respectively. The kappa value for intra-observer agreement was 0.698 (observer 1, P = 0.000), 0.766 (observer 2, P = 0.000) and 0.716 (observer 3, P = 0.000) in PSP method, and 0.816 (observer 1, P = 0.000), 0.653 (observer 2, P = 0.000) and 0.744 (observer 3, P = 0.000) in CBCT method. CONCLUSION This in vitro study, with a limited number of samples, showed that the New Tom VGI Flex CBCT system was more accurate than the PSP in detecting the simulated small secondary occlusal caries under amalgam restoration.
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Affiliation(s)
- Shoaleh Shahidi
- Department of Oral and Maxillofacial Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahal Kazerooni Zadeh
- Postgraduate Student, Department of Oral and Maxillofacial Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farahnaz Sharafeddin
- Department of Operative Dentistry, Biomaterial Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahriar Shahab
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahed University, Tehran, Iran
| | - Ehsan Bahrampour
- Department of Oral and Maxillofacial Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Hamedani
- Dental Research Development Centre, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran,Address for correspondence: Dr. Shahram Hamedani, Dental Research Development Centre, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail:
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