The aims of this study were to evaluate the frequency of errors in panoramic radiographs in young orthodontic patients, to register pathologic and abnormal conditions, and to compare these findings with the patient's record. A total of 1287 panoramic radiographs of children and adolescents (530 boys and 757 girls; mean age 14.2 years) were analyzed. The radiographs were obtained of patients referred for orthodontic treatment during a 1 year period. Four observers evaluated the radiographs for 10 common errors, pathologies, and/or anomalies. Cohen's kappa was used for the calculations of inter- and intraobserver variability. Five of the errors were divided into clinically relevant or not clinically relevant errors, i.e. errors influencing diagnosis. Only those pathological findings with a possible influence on orthodontic treatment were compared with the patient's record. Of the 1287 radiographs, 96 per cent had errors. The number of errors in each image varied between 1 and 5, and in 24 per cent of these images, the errors could be of importance for clinical decision making. The most common error was that the tongue was not in contact with the hard palate. Pathologies or anomalies were found in 558 patients and a total of 1221 findings were recorded. Findings of possible relevance for orthodontic treatment were 63, and 12 of those were registered in the patient records. Pathological findings outside the dental arches were low and could be an argument for minimizing the radiation field.
The results revealed high reliability of measurements performed on CBCT images independently from object position, examiner's experience and high reproducibility in repeated measurements settings.
The aim was to evaluate, in a 3-year RCT study, school-based fluoride varnish programme on approximal caries incidence and approximal caries progression in 13- to 16-year-olds in high, medium and low caries risk areas on the Swedish west coast. Seven hundred and fifty-eight (89%) fulfilled the trial. Using a simple mobile unit, 2 dental nurses treated the adolescents with F varnish: (1) twice a year at 6-month intervals, (2) 3 times a year within 1 week, (3) 8 times per year during the semesters with 1-month intervals, and (4) no treatment (control). Radiographic caries recording was performed blindly by one of the authors. Concerning total approximal caries incidence, control groups in all areas developed more caries than F varnish groups, with the largest difference in the high risk area: 3.05 ± 3.37 new approximal caries lesions (mean ± SD) compared to 0.54 ± 1.26 for group 3, 0.95 ± 1.67 for group 1 and 1.40 ± 1.89 for group 2 (p < 0.001). More than 90% of the new approximal lesions in all the groups and in all areas consisted of new enamel lesions. Regarding progression of enamel lesions, there were only significant differences between groups 1–3 and group 4 in the high caries risk area. Prevented fraction for fluoride varnish treatment twice a year at 6-month intervals was 69% in high, 66% in medium and 20% in low risk areas. To conclude, school-based F varnish treatment every 6 months in 13- to 16-year-olds is excellent to prevent approximal caries in medium and high caries risk areas.
In two groups of patients, differing in caries prevalence, the restorative treatment of posterior approximal surfaces in permanent teeth was studied in radiographs obtained as part of the dental care provided from age 6 up to and including age 18. The study determined at what age, at which lesion depth and in which surfaces restorative treatment was performed. Furthermore, the conditions of nonrestored dentin lesions were evaluated over time. Nearly 50% of the restorations were placed in the mesial surface of the first molars. In both groups more than 2/3 of the restorations were placed in surfaces with dentin lesions. In the group with the highest caries prevalence 50% of the lesions in the outer half of the dentin were restored when first detected in contrast to 20% in the groups with the lower prevalence. For the superficial dentin lesions not immediately restored, average time between their detection and restoration, the end of the study or, detection in the inner half of the dentin was practically the same in both groups (19.3 and 20.4 months). The variation in this average time was only to a limited degree explained by the variation in the caries experience of the patients.
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