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Background: The clinical presentation, radiographic features, and histopathological findings of a case of ameloblastic fibro-odontoma are described. The clinical and radiographic presentations of this case are typical of this benign odontogenic tumor. The patient was young and asymptomatic with the exception of the clinical absence of the permanent mandibular left first molar. Treatment consisted of simple enucleation with removal of the primary mandibular left second molar., Methods: A panoramic image and cone beam computed tomography (CBCT) scan were acquired in order to determine the reason for clinical absence of the permanent mandibular left first molar. The CBCT image proved to be a valuable supplement to the conventional radiographic examination as it provided information not apparent on the 2-dimensional panoramic image. Both the extent of the lesion and its effects on adjacent structures were better delineated with CBCT. Additionally, the presence of calcifications, an important radiographic characteristic of this particular lesion, were visible on CBCT versus the panoramic image., Conclusions: This case report demonstrates that the CBCT scan provided important management and treatment planning information that was not apparent in the panoramic image.

Objective: The aims of this study were (1) to subjectively quantify the degree of scratching and smudging that had taken place in the junior clinic in the 9 months following the implementation of digital radiology; (2) to compare the findings with a previously published report; and (3) to identify areas in the protocol and training that can be refined to minimize future scratching and smudging., Methods: Seven sets of blank clinical photostimulable storage phosphor (PSP) plates were scanned after exposing them at 65 kV and 7 mA for 0.80 s. Scanned plates were lightly wiped with a soft cloth and alcohol, repackaged in plastic sleeves, re-exposed and rescanned. The two sets of resulting images were subjectively rated independently by two investigators for artefacts and placed in five categories., Results: Of all the images, approximately 75% were rated in the top 3 categories (most readable), leaving 17% and 8% in the poor and unsatisfactory categories, respectively. Mean rated values of the two image sets (before and after wiping) were not statistically different, but ratings slightly improved after cleaning the plates., Conclusions: Wiping all plates to remove surface contamination may not always be necessary or desirable. Systems that are designed to minimize handling of the plates may help minimize scratching of them.

Objective: The objective of this study was to determine if phosphor plates used in predoctoral clinics are microbiologically contaminated and to identify the source of contamination., Study Design: Forty-five of 300 phosphor plates (15%) were randomly selected for examination. The plates were pressed into individual blood agar plates, were incubated using standard techniques at 37 degrees C, and were monitored for 72 hours. The number, size, distribution, and variety of resulting colonies were noted. A representative of each type of colony was selected to be Gram stained using the standard technique., Results: Of the plates, 42.2% were uncontaminated, 57.8% yielded bacterial colonies, and 15.6% of those colonies demonstrated hemolytic growth. The hemolytic growth included combined alpha and beta hemolysis and beta only hemolysis. Six colonies were gram-positive rods and 7 were gram-positive cocci., Conclusion: Meticulous infection-control techniques are inevitable and continuous reinforcement and training for staff and students are mandatory. Periodic gas sterilization of phosphor plates may be necessary.

Objectives: To compare the accuracy of local computed tomography (LCT) and conventional radiography for proximal caries detection and depth assessment., Study Design: An in vitro model was used consisting of 20 extracted posterior teeth with 18 caries lesions. Local computed tomography slices were reconstructed in axial and parasagittal planes from 100 basis projections. Conventional radiographs were also acquired. Eight observers determined the presence and depth of caries lesions. Receiver operating characteristic analysis and weighted kappa statistics were used., Results: Local computed tomography had a mean A(z) score of 0.82 (SD = 0.07) and conventional radiography of 0.79 (SD = 0.08; analysis of variance: P > .05). Interobserver agreement was moderate. The mean kappa for depth assessment was 0.68 (SD = 0.06) for LCT and 0.47 (SD = 0.08) for conventional radiography (analysis of variance: P < .05). Local computed tomography resulted in substantial and conventional radiography in moderate interobserver agreement., Conclusions: There is no difference between LCT and conventional radiography for proximal caries detection. Local computed tomography was more accurate for assessing caries lesion depth.

Objectives: To investigate the artefacts caused by different disinfection and protection methods that can be used for infection control of photostimulable phosphor (PSP) plates., Methods: The plates that were enveloped with single or double envelopes were sprayed with an alcohol-containing solution or wiped with an alcohol-containing tissue. Four PSP groups with two plates in each group were formed (A = wiping single envelope, B = wiping double envelopes, C = spraying onto single envelope, and D = spraying onto double envelopes). Any artefacts (1 = no artefact, 2 = presence of artefact less than 0.5 cm wide, and 3 = presence of artefact larger than 0.5 cm wide) on the 12 acquired images were evaluated., Results: Artefacts (score-3) occurred on the images of Group C-2 PSP plate after the 3rd exposure. According to the Kruskal-Wallis test the difference between the artefact score of the four methods was found significant. Post-hoc comparisons showed the Group C artefact scores were higher than the others and the difference was significant. The total time of enveloping and disinfection processes for groups was; A = 6.30 min, B = 7.58 min, C = 5.48 min, and D = 7.14 min., Conclusions: Regardless of the number of envelopes, wiping with a tissue was less likely to cause artefacts, while spraying was reliable only when double envelopes were used. However, using a tissue and double envelopes, which are less risky in terms of artefact, causes time loss, difficulty in manipulation, environmental pollution and high cost., (© 2022. The Author(s) under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology.)

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. [ABSTRACT FROM AUTHOR]

Objectives: Artifacts including scratches and dirt artifacts on the digital intraoral radiographs finally contribute to making inaccurate diagnoses. The aim of this study was to reduce the incidence of artifacts using dual imaging plates (DIPs) in imaging processing. Methods: Conventional X-rays were taken of a porcine mandible embedded in acrylic resin using a DIP which consists of a front IP (FIP) and a back IP (BIP) with some scratches and dirt. The two images of the FIP and BIP were then synthesized and averaged to obtain a conventional DIP image. The following image processing method was used to make a DIP with artifact reduction (DIP+AR) image. A subtraction image of the FIP and BIP was constructed and the standard deviation (SD) was calculated. If the pixel value was over 3SD on the subtraction images, the pixel value of the DIP was swapped with the value on the opposite side of the non-artifact pixel. The conventional and DIP+AR images were also subjectively evaluated. Results: Image processing to create a DIP+AR image was able to reduce the number of artifacts. Medians of number of artifacts evaluated were 2.00 [interquartile range (IQR), 2.50] in DIP images and 0.67 (IQR, 1.29) in DIP+AR images, indicating a significant reduction of number of artifacts in DIP+AR images. Conclusions: DIP+AR image processing can reduce the incidence of artifacts caused by scratches and dirt, and could extend the lifespan of the IP and contribute accurate diagnosis in oral radiology. [ABSTRACT FROM AUTHOR]

To develop and test a protective device (PD) to increase the resistance of photostimulable storage phosphor (PSP) plate to compressive load, and assess the resulting image quality. Two prototypes, polyvinylchloride sheets of 0.3 mm and 0.7 mm each, were developed for PSP plate size 2. The resistance to compressive load was tested using eight new PSPs divided into four test groups: (1) PSP, (2) PSP and paperboard protector, (3) PSP and 0.3 mm PD, and (4) PSP and 0.7 mm PD. The resulting images were analyzed by three oral radiologists, based on the consensus for image artifacts. Additionally, the objective image quality test was performed with four new PSPs, using an 8-step wedge aluminum scale. The mean gray values and standard deviation were measured in a total of 240 images, and the data were analyzed using analysis of variance with Bonferroni post-hoc test. Artifacts were seen in the PSP control group starting at 40 n, and at 150 n, 175 n and 300 n in 0.3 mm PD, paperboard protector and 0.7 mm PD, respectively. Although there was no statistical difference among groups, there were differences between exposure times (0.06–0.25 s, 0.06–0.40 s, and 0.10–0.40 s). Scanning resolution of 20 lp/mm showed higher mean gray value than 25 and 40 lp/mm (p < 0.05) The developed PDs improved the PSP resistance to compressive forces, with low interference on the pixel gray values, regardless of exposure time and spatial resolution. Nevertheless, the 0.7 mm PD could withstand the maximum compressive load. [ABSTRACT FROM AUTHOR]

Dental health care workers are subjected to various infectious disease agents that are present in patients' saliva and blood which make infection control and universal prevention methods indispensable to the dental practice given that some of these diseases cause loss of work and time for dental staff and patients; some of them cause serious morbidity; and some of them currently have a poor prognosis and no effective treatments. Although dental radiographic procedures are not invasive, and there are no incidents such as injuries caused by dental instruments, they are a potential infection source because of contamination with saliva and blood, and comprehensive infection control procedures also apply to the radiology clinic. In addition, contact with a large number of patients in dental schools and clinics in a short period of time, and the fact that radiographic procedures are performed in the same environment as other dental procedures in dental offices increase the significance of infection control in dental radiology. Major advances in computer technology have enabled digital imaging systems to develop rapidly and to become common in dental practice as an alternative to conventional film-based imaging. The use of digital sensors in dental radiology introduced unique infection control challenges and required the revision and modification of existing infection control techniques. In this review, studies concerning the risk of cross-contamination and challenges of infection control with digital image sensors are comprehensively reviewed and infection control protocols that should be followed in intraoral digital imaging using both direct and indirect systems are thoroughly examined. [ABSTRACT FROM AUTHOR]

Learning bone anatomy of the skull is a complex topic involving three‐dimensional information. The impact of the use of human dry skulls and cone beam computed tomography (CBCT) imaging was investigated in the teaching of undergraduate dental students. Sixty‐four first‐year students in the University of Hong Kong were randomly divided into eight groups. Four teaching methods were tested: (1) CBCT followed by standard lecture, (2) CBCT followed by lecture with skulls, (3) standard lecture followed by CBCT, and (4) lecture with skulls followed by CBCT. After each, students were given a multiple‐choice questionnaire to assess their objective learning outcome (20 questions) and a questionnaire for their subjective satisfaction (10 statements). Surveys were assessed with Cronbach's alpha, Kendall's tau‐b, and principal components analysis. Data were analyzed with Student's t‐test and a one‐way ANOVA (significance α = 0.05). Standard lecture followed by CBCT showed the highest learning outcome score (81.6% ± 14.1%), but no significant difference was present among four teaching methods. Cone beam computed tomography followed by lecture with skulls scored the highest overall subjective satisfaction (4.9 ± 0.8 out of 6), but no significant difference was present among teaching methods. Nevertheless, students' perception of learning was positively influenced by the use of skulls (P = 0.018). The timing of administration of the CBCT did not affect students' subjective satisfaction or objective learning outcome. Students perceived to learn more by using skulls, but their objective learning outcomes were not significantly affected. A discrepancy seems to exist between students' perception of learning and their effective performance. [ABSTRACT FROM AUTHOR]

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]

Purpose: The aim of this study was to determine the reasons and solutions for intraoral phosphor storage plate (PSP) image artifacts and errors, and to develop an appropriate classification of the artifacts. Materials and Methods: This study involved the retrospective examination of 5,000 intraoral images that had been obtained using a phosphor plate system. Image artifacts were examined on the radiographs and classified according to possible causative factors. Results: Artifacts were observed in 1,822 of the 5,000 images. After examination of the images, the errors were divided into 6 groups based on their causes, as follows: images with operator errors, superposition of undesirable structures, ambient light errors, plate artifacts (physical deformations and contamination), scanner artifacts, and software artifacts. The groups were then re-examined and divided into 45 subheadings. Conclusion: Identification of image artifacts can help to improve the quality of the radiographic image and control the radiation dose. Knowledge of the basic physics and technology of PSP systems could aid to reduce the need for repeated radiography. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the effect of different spatial resolutions of a photostimulable phosphor plate (PSP) radiography system on the detection of proximal caries lesions. Materials and Methods: Forty-five extracted human permanent teeth were radiographed using a PSP system (VistaScan Perio Plus) and scanned at the 4 resolutions (10 lp/mm, 20 lp/mm, 25 lp/mm, and 40 lp/mm) available in the system. Three independent examiners scored the images for the presence and absence of proximal caries lesions using a 5-point scale. The presence or absence of caries was confirmed by histological sections of the examined teeth (defined as the gold standard). Intra- and inter-observer reproducibility was calculated by the weighted kappa test. One-way analysis of variance with the post hoc Tukey test was used to compare the area under the receiver operating characteristic curve for the classifications made with each resolution. results: For the detection of enamel lesions, the spatial resolution of 10 lp/mm was significantly superior to the other resolutions. However, the spatial resolution did not affect the detection of caries lesions in dentin (P>0.05). conclusion: Spatial resolution may influence the accuracy of the detection of incipient caries lesions in radiographs with PSP plates. Images with low spatial resolution seem to be more appropriate for this purpose. [ABSTRACT FROM AUTHOR]

Diagnosis of caries of proximal surfaces of the posterior teeth, especially in its early stages, is a clinical challenge. The aim of this literature review is to present the available methods for the detection of carious lesions on the proximal surfaces of permanent teeth, especially at earliest stages. Early detection of dental caries allows establishing preventive measures and minimal invasive techniques. Nowadays, various methods and tools exist for the proximal carious detection. Fluorescence laser and LED devices have high specificity when carious lesions extend to inner third of dentine. Periapical and bitewing radiographs, in their conventional or digital form, exhibit high specificity but low sensitivity, which can result to sound dental tissue removal. Panoramic radiographs should not be taken into account for the detection of carious lesions, as their diagnostic accuracy is outperformed by periapical radiographs. Computed tomography shows higher rates of sensitivity and specificity in dentine lesions. Satisfactory rates of sensitivity and specificity are presented by optical methods, especially when they are made on the basis of clinically!based protocols such as the clinical ICDAS criteria. In conclusion, as reported by the various studies between the methods there are not significant differences, so that some of them do not significantly outweigh. The optical method using detection protocols with or without the use of reinforcing tools should remain the basic method of detecting carious lesions. [ABSTRACT FROM AUTHOR]

Objectives The aim of this pictorial review is to illustrate the use of CBCTin a broad spectrum of musculoskeletal disorders and to compare its diagnostic merit with other imaging modalities, such as conventional radiography (CR),Multidetector Computed Tomography (MDCT) and Magnetic Resonance Imaging. Background Cone Beam Computed Tomography (CBCT) has been widely used for dental imaging for over two decades. Discussion Current CBCT equipment allows use for imaging of various musculoskeletal applications. Because of its low cost and relatively low irradiation, CBCT may have an emergent role in making a more precise diagnosis, assessment of local extent and follow-up of fractures and dislocations of small bones and joints. Due to its exquisite high spatial resolution, CBCT in combination with arthrography may be the preferred technique for detection and local staging of cartilage lesions in small joints. Evaluation of degenerative joint disorders may be facilitated by CBCTcompared to CR, particularly in those anatomical areas in which there is much superposition of adjacent bony structures. The use of CBCT in evaluation of osteomyelitis is restricted to detection of sequestrum formation in chronic osteomyelitis. Miscellaneous applications include assessment of (symptomatic) variants, detection and characterization of tumour and tumour-like conditions of bone. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to evaluate microbial contamination in phosphor storage plates in dental radiology services and discuss the possible origin of this contamination. Materials and methods: The sample comprised 50 phosphor plates: 14 plates from service A, 30 from service B, and 6 in the control group, consisting of plates never used. Damp sterile swabs were rubbed on the phosphor plates, and then transferred to tests tubes containing sterile saline solution. Serial dilutions were made, and then inoculated in triplicate on Mueller Hinton agar plates and incubated at 37 °C/48 h, before counting the colony-forming units (CFU). The samples were also seeded in brain-heart infusion medium to confirm contamination by turbidity of the culture medium. All solutions, turbid and clean, were seeded in selective and non-selective media. Results: At service A and B, 50 and 73.3 % of the phosphor plates were contaminated, respectively. This contamination was mainly due to bacteria of the genus Staphylococcus. CFU counts ranged from 26.4 to 80.0 CFU/plate. Conclusions: Most of the phosphor plates evaluated shown to be contaminated, mainly by Staphylococcus ssp. Quantitatively, this contamination occurred at low levels, possibly arising from handling of the plates. The use of a second plastic barrier may have diminished contamination by microorganisms from the oral cavity. Clinical relevance: There is a risk of cross-contamination by phosphor storage plates used in dental radiology services. [ABSTRACT FROM AUTHOR]

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Objectives: Proximal dental caries remains a prevalent disease with only modest detection rates by current diagnostic systems. Many new systems are available without controlled validation of diagnostic efficacy. The objective of this study was to evaluate the diagnostic efficacy of three potentially promising new imaging systems. Methods: This study evaluated the caries detection efficacy of Schick 33 (Sirona Dental, Salzburg, Austria) intraoral digital detector images employing an advanced sharpening filter, Planmeca ProMax® (Planmeca Inc., Helsinki, Finland) extraoral "panoramic bitewing" images and Sirona Orthophos XG3D (Sirona Dental) CBCT images with advanced artefact reduction. Conventional photostimulable phosphor images served as the control modality. An ex vivo study design using extracted human teeth, ten expert observers and micro-CT ground truth was employed. Results: Receiver operating characteristic analysis indicated similar diagnostic efficacy of all systems (ANOVA p.0.05). The sensitivity of the Schick 33 images (0.48) was significantly lower than the other modalities (0.53-0.62). The specificity of the Planmeca images (0.86) was significantly lower than Schick 33 (0.96) and XG3D (0.97). The XG3D showed significantly better cavitation detection sensitivity (0.62) than the other modalities (0.48-0.57). Conclusions: The Schick 33 images demonstrated reduced caries sensitivity, whereas the Planmeca panoramic bitewing images demonstrated reduced specificity. XG3D with artefact reduction demonstrated elevated sensitivity and specificity for caries detection, improved depth accuracy and substantially improved cavitation detection. Care must be taken to recognize potential false-positive caries lesions with Planmeca panoramic bitewing images. Use of CBCT for caries detection must be carefully balanced with the presence of metal artefacts, time commitment, financial cost and radiation dose. [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: This study aimed to assess the perforation rate of intraoral barriers for a direct digital sensor according to the barrier application. Methods: Four types of plastic barriers with different thicknesses and one type of latex finger cot were applied using six modified techniques. The perforations in barrier samples of six groups were examined by a water pressure test. The differences in the perforation rates among the six barrier applications were calculated. Results: The least perforation occurred in Group 4 (0.08-mm-thick single barrier, 22%) and the most in Group 1 (0.04-mm-thick single barrier, 58%). An ANOVA test revealed statistical differences in the perforation rate among the groups (p = 0.00; 95% confidence interval, 0.326-0.403). [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]

Purpose: This study assessed the effectiveness of three antimicrobial mouthrinses in reducing microbial growth on photostimulable phosphor (PSP) plates. Materials and Methods: Prior to performing a full-mouth radiographic survey (FMX), subjects were asked to rinse with one of the three test rinses (Listerine®, Decapinol®, or chlorhexidine oral rinse 0.12%) or to refrain from rinsing. Four PSP plates were sampled from each FMX through collection into sterile containers upon exiting the scanner. Flame-sterilized forceps were used to transfer the PSP plates onto blood agar plates (5% sheep blood agar). The blood agar plates were incubated at 37°C for up to 72 h. An environmental control blood agar plate was incubated with each batch. Additionally, for control, 25 gas-sterilized PSP plates were plated onto blood agar and analyzed. Results: The mean number of bacterial colonies per plate was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse negative control groups. Only the chlorhexidine and Listerine groups were significantly different (p=0.005). No growth was observed for the 25 gas-sterilized control plates or the environmental control blood agar plates. Conclusion: The mean number of bacterial colonies was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse groups. Nonetheless, a statistically significant difference was found only in the case of Listerine. Additional research is needed to test whether a higher concentration (0.2%) or longer exposure period (two consecutive 30 s rinse periods) would be helpful in reducing PSP plate contamination further with chlorhexidine. [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]

Objective: The aim of this study was to compare the accuracy of cone beam CT (CBCT) with intraoral radiographs for detection of occlusal caries. Methods: A set of 60 extracted teeth were imaged using a Sirona Galileos CBCT system (Sirona Dental Systems, Bensheim, Germany) and an intraoral Planmeca® system (Planmeca OY, Helsinki, Finland). Six observers looked at both modalities and used a five-point confidence scale to evaluate presence or absence of occlusal caries. Histology was used as the gold standard. Receiver operating characteristic analysis and weighted kappa statistics were used for statistical analysis. Differences in the area under the curve (AUC) values between observers and modalities were analysed using analysis of variance (ANOVA). Differences in sensitivity and specificity were analysed using the Wilcoxon test. Interobserver and intraobserver reliability was assessed by weighted kappa scores. Results: The mean value and standard deviation of AUC was 0.719 ± 0.038 for CBCT and 0.649 ± 0.062 for the intraoral radiographs. The ANOVA results demonstrated that there was no significant difference between the modalities and the observers. The interobserver kappa for pairs of observers ranged from fair to substantial for bitewings (0.244-0.543) and CBCT (0.152-0.401). Four out of six observers reported higher sensitivity but lower specificity with CBCT. The Wilcoxon exact p-value showed no difference in sensitivity (0.175) or specificity (0.573) between the two modalities. Conclusion: Based on the results we conclude that the Sirona CBCT unit cannot be used for the sole purpose of looking at occlusal caries. [ABSTRACT FROM AUTHOR]

Objectives: To assess the durability of the imaging plates (IP) supplied with the Digora Optime digital imaging system in terms of their functionality after as many as 1000 exposures and the degree of signal fading that occurred after a delay of up to 144 h between exposure and scanning Methods: The materials examined consisted of eight IPs. Three new and three used IPs were tested for signal fading, and the other two new IPs were exposed 1000 times and then tested for durability. The first exposure image data were used as baseline for comparison. The exposed IPs were then scanned 0, 5, 10, 30, and 60 min, and 3, 24, 72, and 144 h after exposure. Images without automatic gain control were used in both analyses. These images were exported as 24-bit tiff files with 8-bit gray value data, and mean gray values (MGVs) were measured and compared. Image gray value (IGV) in each image was calculated for statistical analysis. Immediately scanned pixel data were used as baseline for comparison. Statistical analysis was performed by ANOVA and use of Dunnett's multiple comparison test ( P < 0.05). Results: There were no significant differences for up to 1000 exposures, and no significant difference was observed among images scanned with a delay of up to 3 h in new and used IPs. There was no significant difference between new and used IPs. [ABSTRACT FROM AUTHOR]

Objectives: Conventional radiographic imaging of teeth underestimates the presence of caries. The objective of this study was to compare the efficacy of high-resolution cone beam CT (CBCT) images and conventional charge-coupled device (CCD) images for detecting proximal and occlusal caries. Methods: Non-restored, extracted human permanent premolar and molar teeth were mounted and then imaged with a 3DX Accuitomo® and a CCD. We selected 92 occlusal and 100 proximal surfaces for raters to score. Of these, 36 and 25, respectively, had lesions extending into dentin. Using a five-step confidence scale, eight practising dentists evaluated the images for the presence of caries in dentin using both modalities. Actual presence and extent of caries was established with microCT imaging. Results: For proximal surface lesions extending into dentin, the average sensitivity score using 3DX images (0.61) was almost twice that of CCD images (0.33) and the difference was significant. The specificity values for both systems were high and not significantly different from each other. For occlusal surfaces, raters detected significantly more lesions in the enamel or dentin when using the 3DX images than when using CCD images. However, the raters also had significantly lower average specificity scores for the 3DX images compared with the CCD images for lesions at both depths. Conclusions: Practising dentists were able to improve their detection of proximal-surface caries extending into the dentin, but not occlusal caries, using 3DX high-resolution cone beam CT images compared with CCD images. [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]