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Objective: Current diagnostic tools for non-cavitated occlusal caries are not very reliable. For this reason, newer systems need to be developed. The aim of this study was to compare the performance of visual inspection (ICDAS-II), laser fluorescence (DIAGNOdent pen), and the near-infrared transillumination technique (DIAGNOcam) in the detection of non-cavitated occlusal caries lesions under clinical and laboratory conditions in 90 third molar teeth planned for extraction. Materials and Methods:Ninety third molar teeth were firstly examined in clinical conditions, scored according to ICDAS-II criteria, and examined with DIAGNOdent pen and DIAGNOcam devices. After finishing the clinical examination, the teeth were re-evaluated shortly after the extractions with the same methods. Then, the teeth were sectioned for histological validation according to Downer’s criteria. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curves were calculated based on the histological results. Results: For the D0–D1–4 threshold, the area under the ROC curve values ranged between 0.754 and 0.881 for all systems. Sensitivity values ranged between 80.5 and 96.1%, and specificity values ranged between 61.5 and 84.6% for the three caries detection methods. DIAGNOcam had the best correlation value (0.616) according to histological observations and demonstrated a sensitivity rate of 96.1%, a specificity rate of 61.5%, and an accuracy rate of 91.1%. Conclusions: DIAGNOcam was found to be the most effective method for the diagnosis of occlusal caries without cavitation in permanent molar teeth.

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PurposeThe aim of this study was to compare cone-beam computed tomography (CBCT) and digital panoramic radiography (DPR) for the detection of pulp stones.Materials and MethodsDPR and CBCT images of 202 patients were randomly selected from the database of our department. All teeth were evaluated in sagittal, axial, and coronal sections in CBCT images. The systemic condition of patients, the presence of pulp stones, the location of the tooth, the group of teeth, and the presence and depth of caries and restorations were recorded. The presence of pulp stones in molar teeth was compared between DPR and CBCT images.ResultsPulp stones were identified in 105 (52.0%) of the 202 subjects and in 434 (7.7%) of the 5,656 teeth examined. The prevalence of pulp stones was similar between the sexes and across various tooth locations and groups of teeth (P>.05). A positive correlation was observed between age and the number of pulp stones (ρ=0.277, P<.01). Pulp stones were found significantly more often in restored or carious teeth (P<.001). CBCT and DPR showed a significant difference in the detection of pulp stones (P<.001), which were seen more often on DPR than on CBCT.ConclusionDPR, as a 2D imaging system, has inherent limitations leading to the misinterpretation of pulp stones. Restored and carious teeth should be carefully examined for the presence of pulp stones. CBCT imaging is recommended for a definitive assessment in cases where there is a suspicion of a pulp stone on DPR.

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Objective: Third molar impaction is seen much more than impaction of any other tooth as they are the last teeth to erupt. Inadequate retromolar space and the direction of eruption may be contributing factors. The aim of this study was to investigate the relationship between third molar impaction and different skeletal face types. Subjects and Methods: Panoramic and lateral cephalometric radiographs of 158 orthodontic patients (aged 19–25 years) were retrieved from the archived records of the Necmettin Erbakan University Faculty of Dentistry, Konya, Turkey. Third molar impaction was classified on the basis of Winter’s classification. The skeletal facial type was determined by a measure of the angle created by the lines Ba-Na and Pt-Gn. The mean was 90 ± 2 and this value was regarded as mesofacial. An angle of > 93° was regarded as brachyfacial and an angle of < 87° as dolichofacial. Results: The overall presence of mandibular and maxillary third molar impactions was 65.2 and 38.6%, respectively. Although there was a statistically significant difference between different skeletal facial types and mandibular third molar impaction (p < 0.05), no statistically significant differences were observed between different skeletal facial types and maxillary third molar impaction (p > 0.05). Brachyfacials demonstrated a lower prevalence of third molar impaction than dolichofacials. Conclusions: Different skeletal face types were associated with mandibular third molar impaction. Brachyfacials, who have a greater horizontal facial growth pattern than dolichofacials, showed a lower prevalence of impacted mandibular third molars.

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BackgroundOur purpose was to investigate the relationship between the angulation of mandibular third molars and the thickness of the lingual bone, which can affect the risk of lingual nerve damage during lower third molars surgical extraction.Material and MethodsThis study consisted of 104 patients (42 males and 62 females), aged between 18-42 years (24.67 ± 6.11 years). Cone Beam Computed Tomography (CBCT) images were taken for preoperative assessment. The teeth were divided into four groups according to their positions: mesioangular, distoangular, vertical and horizontal. Lingual bone thickness around impacted teeth were measured at three points: cementoenamel junction (CEJ) of the mandibular second molar, mid-root of the impacted third molar, and apex of the impacted third molar root. Two predisposing factors of lingual nerve damage were recorded: lingual bone perforated by the impacted tooth and lingual bone thinner than 1 mm. Additionally, buccolingual angulations of the teeth in each group were measured. Impacted mandibular third molars were removed in usual way. One week after surgery, the patients were evaluated regarding lingual nerve paresthesia.ResultsNone of the 104 patients experienced paresthesia, including the ones who had teeth with close proximity with lingual nerve. The mean thickness of bone was 1.21±0.63 mm at CEJ of the second molar; 1.25±1.02 mm at the mid-root; and 1.06±1.31 mm at the apex. Horizontally impacted teeth had thinner lingual bone at mid-root level (p=0.016). Buccolingual angulated teeth were more often associated with perforated lingual bone (p=0.002). Buccolingual and mesial/distal angulation had negative correlation with lingual bone thickness (p<0.05).ConclusionsAs the buccolingual and mesiodistal angulations increase, lingual bone thickness decreases. Horizontally impacted teeth seemed to compromise the integrity of the lingual bone more than impacted teeth in other positions. During the surgery, thin or perforated lingual bone may result in displacement of the impacted tooth lingually. Key words:Lingual bone, impacted third molar, cone beam computed tomography, angulation, paresthesia.