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Objectives: To investigate the influence of orthodontic materials, field of view (FOV), and artifact reduction (AR) on the assessment of approximal caries using cone beam computed tomography. Materials and methods: Forty non-cavitated and restoration-free human premolars and molars ranging from sound to various grades of lesions without cavitations were assigned to 13 groups with different combination of fix appliance equipment. CBCT (cone beam computed tomography) (Planmeca ProMax 3D Mid, Helsinki, Finland) images were obtained using combinations of three orthodontic bracket materials and two orthodontic archwire with small and large FOVs and with and without AR activation. Receiver operating characteristic (ROC) analysis was used to calculate the area under the ROC curve (AUC). Results: Interobserver agreement ranged from 0.44 to 0.92 and intraobserver agreement ranged from 0.50 to 0.99. Teeth lacking orthodontic materials had the highest Az values at 0.84. FOV and AR activation did not significantly affect AUC values (P > 0.05). The AUC data were significantly reduced by the addition of stainless steel wire, NT wire, or a combination of a stainless steel bracket with stainless steel wire (P < 0.05). Conclusions: The addition of stainless steel wire, NT wire, or a stainless steel bracket with stainless steel wire combination prevented the diagnosis of non-cavitated interproximal tooth caries by CBCT. With and without AR modes and different FOVs did not influence the diagnosis of interproximal caries lesions with different types of orthodontic equipment. Clinical relevance: A wide variety of brackets and wire combinations are used in the clinic; however, the extent to which these combinations impact the diagnosis of caries by CBCT as the effects of FOV and AR algorithms are unknown. [ABSTRACT FROM AUTHOR]

Statement of the problem: Presently, various imaging methods are available for the disclosure of proximal caries. Some recent studies have attempted to determine the diagnostic accuracy of available modalities, but they have shown variable results. Aim: This study was carried out to recognize and examine the correctness of cone-beam computed tomography (CBCT), regular radiographs and the nondirect digital system in the disclosure of interproximal caries. Materials and Method: In this observational tryout study, forty-two extracted non-cavitated, unrestored person molar and premolar teeth were placed in the blocks with proximal surfaces in touch. Then they were appraised by CBCT, formal radiographs and the nondirect digital system for the disclosure of interproximal caries. Four oral and maxillofacial radiologists used a 4-point scale to assess the pictures for the existence or absence of proximal caries. Caries depth was specified by histological examination. The gathered data were assessed by SPSS software using Weighted Kappa and Friedman test. Results: Statistics demonstrated that the accuracy of the indirect digital system was somewhat better than conventional systems. The accuracy of the indirect digital system was better than cone beam system, and this difference was statistically significant. Conclusion: The digital system was better than CBCT in the disclosure of proximal caries. The formal radiography fell in between the two other systems without a statistically significant deviation in detecting caries. Thus, CBCT is not advised to detect proximalcaries because of the higher radiation dose. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this in vitro study was to compare the diagnostic accuracy of different radiographic imaging modalities in detecting occlusal caries lesions. Materials and Methods: Under standardized conditions, 125 extracted human permanent molar teeth with sound or occlusal caries lesions were radiographed using a conventional film system (F-speed), a direct digital imaging system (complementary metal oxide semiconductor sensor), an indirect digital imaging system (photostimulable phosphor plate) and a cone beam computed tomography system (CBCT). Two observers scored the resultant images for the presence or absence of caries. Then, the teeth were histologically prepared and a definite diagnosis was determined by stereomicroscopic assessment. The area under the receiver operating characteristic curve (Az), sensitivity, specificity and accuracy of each imaging modality were calculated, as well as the intra- and interexaminer reproducibility. Results: For both thresholds, interexaminer agreement were higher for CBCT. For intraexaminer agreement, observers had different scores for both thresholds, but the scores were generally higher for CBCT. Similar Az values were achieved with all imaging methods at a diagnostic D1 threshold. The Az values of the CBCT system were found to be statistically higher than those of the other imaging modalities at a diagnostic D3 threshold (p > 0.05); no significant differences were found among the other imaging modalities. All radiographic methods showed similar sensitivities, specificities and accuracy in detecting D1 threshold. The CBCT system showed higher sensitivity and accuracy in detecting dentine lesions. Conclusions: Within the limitations of this study, CBCT exhibited better performance in detecting deep occlusal caries lesions than the other radiographic systems. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background. Treatment strategies have changed with efforts on arresting carious lesions suspected to have an intact surface sparing operative treatment for cavitated lesions. Radiography is still the most recommended adjunct method in the diagnosis of clinically inaccessible approximal surfaces. Bitewing radiography. The major drawback of bitewing radiography for caries diagnosis is that the clinical state of the surface cannot be determined; i.e. if cavitation has developed or the demineralized surface is still intact. Based on studies of the relationship between radiographic lesion depth and clinical cavitation in approximal surfaces, a threshold for operative treatment decision has been suggested when a lesion is observed radiographically more than one-third into dentine. However, the results from previous studies are contradictory and the majority of studies are ∼25 years old. In addition, there are few longitudinal observational studies on the behaviour of dentinal carious lesions, particularly in adults. Cone beam computed tomography. Cone beam CT is an advanced 3-dimensional radiographic modality, which seems much more accurate than intra-oral modalities for displaying cavitation in approximal surfaces. Nonetheless, there are several drawbacks with CBCT, such as radiation dose, costs and imaging artefacts. Therefore, CBCT cannot be advocated at current as a primary radiographic examination with the aim of diagnosing cavitated carious lesions. Conclusions. Bitewing radiography is, thus, still state-of-the-art as an adjunct in diagnosing carious lesions in clinically inaccessible approximal surfaces. The risk for cavitation is related to lesion depth, but new studies are needed in both child and adult populations to validate current thresholds for the operative treatment decision based on the radiographic lesion depth. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the performance of photostimulable storage phosphor (PSP) radiographs with or without using the sharpen filter and cone beam CT (CBCT) for detecting enamel subsurface demineralization. Methods: Enamel subsurface demineralization was induced on one of the approximal surfaces of 120 sound human teeth. Standardized images of all teeth were acquired after the demineralization phase using the Digora® Optime (Orion Corp./Soredex, Helsinki, Finland) (PSP) and the i-CAT™ (Imaging Sciences International, Hatfield, PA) (CBCT) systems. Three calibrated observers interpreted the images using a five-point scale (1, demineralization definitely absent; 2, demineralization probably absent; 3, unsure; 4, demineralization probably present; and 5, demineralization definitely present). Diagnoses were validated by cross-sectional microhardness profiling in the test areas of the approximal surfaces. Interobserver agreement was analysed using kappa statistics. Accuracy was estimated by the areas under the receiver operating characteristic curves (Az), which were compared using the Kruskal-Wallis test (α = 5%). Results: Interobserver agreement was higher for CBCT (κ = 0.7-0.8), followed by sharpen-filtered (κ = 0.6-0.7) and original (κ = 0.5-0.6) images. CBCT presented the highest accuracy value (Az = 0.897) compared with the original (Az = 0.792) and sharpen-filtered (Az = 0.712) images. However, no statistical differences were observed between the imaging modalities (p = 0.0794). Conclusions: It can be concluded that PSP radiographs with or without using the sharpen filter and the CBCT images may be useful adjuncts for detecting subtle approximal enamel demineralization. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]