Cone Beam Computed Tomography- An Effective Tool in Detecting Caries Under Fixed Dental Prostheses

Evaluating the effect of amalgam fillings on caries detection in cone-beam computed tomography images

Background

Dental caries stands as one of the most prevalent dental concerns, with early diagnosis being pivotal in clinical dentistry. Cone-beam computed tomography (CBCT) emerges as a widely utilized modality for dental caries identification, owing to its significant advantages. However, there remains a considerable knowledge gap regarding the efficacy of CBCT scans in detecting dental caries. In line with the as low as reasonably achievable principle, this study endeavors to evaluate the impact of amalgam fillings on the precision of occlusal caries detection in CBCT.

Materials and Methods

This in vitro study employed a set of 102 extracted human teeth samples. Among these, six molar teeth were used to create mesial-occlusal-distal amalgam restorations. The remaining teeth were placed in the dental sockets of a dry human skull to restore proximal contacts. CBCT images were obtained and examined by two observers, while histopathological examination was conducted using a stereomicroscope. Comparative analysis of CBCT images and histopathological data was performed using the McNemar test in SPSS software (α = 0.05).

Results

The McNemar test results indicated that the nonrestoration group showed greater sensitivity and lower specificity in CBCT imaging than the amalgam-restored tooth group.

Conclusion

The findings suggested that the CBCT technique did not demonstrate effectiveness in diagnosing dental caries around amalgam restorations.

Assessment of marginal gaps and image quality of crowns made of two different restorative materials: An in vitro study using CBCT images

Background

The present study assessed the quality of images and the presence of marginal gaps on cone-beam computed tomography (CBCT) images of teeth restored with all-ceramic and metal-ceramic crowns and compared the gap sizes observed on CBCT images with those obtained on micro-CT images.

Methods

Thirty teeth restored with metal-ceramic and all-ceramic crowns, properly adapted and with gaps of 0.30 and 0.50 mm, were submitted to micro-CT and CBCT scans. Linear measurements corresponding to the marginal gap (MG) and the absolute marginal discrepancy (AMD) were obtained. The objective assessment of the quality of CBCT images was performed using the contrast-to-noise ratio (CNR), and the subjective assessment was defined by the diagnoses made by five examiners regarding the presence or absence of gaps.

Results

The measurements were always higher for CBCT, with a significant difference regarding AMD. No significant difference in image quality was observed using CNR between the crowns tested. Low accuracy and sensitivity values could be observed for both crowns.

Conclusion

Marginal mismatch measures were overestimated in CBCT images. No difference in image quality was observed between the crowns. The correct diagnosis of gaps was considered low, irrespective of crown type and gap size.

Radiographic modalities for diagnosis of caries in a historical perspective: from film to machine-intelligence supported systems

Radiographic imaging for the diagnosis of caries lesions has been a supplement to clinical examination for approximately a century. Various methods, and particularly X-ray receptors, have been developed over the years, and computer systems have focused on aiding the dentist in the detection of lesions and in estimating lesion depth. The present historical review has sampled accuracy ex vivo studies and clinical studies on radiographic caries diagnosis that have compared two or more receptors for capturing the image. The epochs of film radiography, xeroradiography, digital intraoral radiography, panoramic radiography and other extraoral methods, TACT analysis, cone-beam CT and artificial intelligence systems aiding in decision-making are reviewed. The author of this review (43 years in academia) has been involved in caries research and contributed to the literature in all the mentioned epochs.