Assessment of enamel demineralization using conventional, digital, and digitized radiography

Ferreira, Rívea Inês; Haiter-Neto, Francisco; Tabchoury, Cínthia Pereira Machado; Paiva, Guilherme Assumpção Neves de; Bóscolo, Frab Norberto

doi:10.1590/s1806-83242006000200005

Cited by 24 publications

(31 citation statements)

References 16 publications

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“…4,5 Radiographic examination is widely used and easy to perform for the diagnosis of approximal caries. [5][6][7][8][9] In the early 1990s, digital radiographic systems were launched, yielding the great possibility of manipulating image brightness and contrast to improve diagnosis. 10 Nevertheless, the radiographic diagnosis of caries lesions depends on the contrast and, therefore, demineralization has to encompass at least 30-40% of the enamel layer to be observed, implying an irreversible mineral loss.…”

Section: Introductionmentioning

confidence: 99%

“…10 Nevertheless, the radiographic diagnosis of caries lesions depends on the contrast and, therefore, demineralization has to encompass at least 30-40% of the enamel layer to be observed, implying an irreversible mineral loss. 8,11 Cone beam CT (CBCT) was developed to address the demand for three-dimensional (3D) information obtained by CT. [12][13][14][15][16][17][18][19][20] The applicability of CBCT images for detecting approximal caries lesions has already been investigated. 4,9,13,18,19,21,22 However, few studies have focused on the diagnostic performance of CBCT for the detection of subtle subsurface enamel demineralization.…”

Section: Introductionmentioning

confidence: 99%

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Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization

Belém¹,

Tabchoury²,

Ferreira-Santos³

et al. 2013

Dentomaxillofacial Radiology

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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 (A z ), which were compared using the Kruskal-Wallis test (a 5 5%). Results: Interobserver agreement was higher for CBCT (k 5 0.7-0.8), followed by sharpenfiltered (k 5 0.6-0.7) and original (k 5 0.5-0.6) images. CBCT presented the highest accuracy value (A z 5 0.897) compared with the original (A z 5 0.792) and sharpen-filtered (A z 5 0.712) images. However, no statistical differences were observed between the imaging modalities (p 5 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. Dentomaxillofacial Radiology (2013Radiology ( ) 42, 20120313. doi: 10.1259 Cite this article as: Belém MDF, Tabchoury CPM, Ferreira-Santos RI, Groppo FC, HaiterNeto F. Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization

Belém¹,

Tabchoury²,

Ferreira-Santos³

et al. 2013

Dentomaxillofacial Radiology

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“…15,17 Clinically, there are more challenges, because in addition to the characteristics of the carious lesion, there are also the inherent troubles associated with the radiographic image 2,3 because caries detection is possible when demineralization has occurred in more than 40% of tooth tissue. 18 The use of secondary caries-like lesions for analysis of observers' performance has been previously applied, 2,12,13,16 and the size of the cavity bears an influence in this performance. 12 In this study, a same-sized bur 12 was used in repeated specimens because the perceptive reliability was an important factor under consideration.…”

Section: Discussionmentioning

confidence: 99%

Influence of Radiopacity of Dental Composites on the Diagnosis of Secondary Caries: The Correlation Between Objective and Subjective Analyses

Cruz

Esteves

Poiate

et al. 2014

Operative Dentistry

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SUMMARY This study aimed to objectively evaluate the radiopacity of different dental composites and their subjective influence on diagnosing secondary caries–like lesions and how these results correlate. For objective analysis, three resin specimens (1 mm thick, with a 4-mm internal diameter) were made with four composites: 1) Charisma; 2) Filtek Z250; 3) Prisma AP.H; and 4) Glacier. Three human teeth were selected and then mesio-distally sectioned (1 mm thick) to make the dental specimens. An aluminum (Al) wedge (12 steps, 1 mm thick, 99.8% purity) was used as an internal standard to calculate the radiopacity. For subjective analysis, 20 human teeth were selected and then prepared with a mesio-occluso-distal (MOD) inlay cavity, with half the teeth receiving a round cavity to simulate the carious lesion. The MOD was restored using the composites at four different times. Standardized radiographs were acquired and then digitized (300 dpi and eight-bit TIFF) for both analyses. A histogram objectively measured the pixel intensity values of the images, which were converted into millimeters of Al using linear regressions. Eight observers subjectively evaluated the images using a five-point rating scale to diagnose the caries. The data were statistically analyzed using the Student t-test, the Kappa test, diagnostic testing, and the Pearson correlation coefficient (α=0.05). All materials showed radiopacity values compatible with dental tissues (p>0.05); Glacier was similar to dentin and Prisma AP.H was similar to enamel, while the remaining materials showed a middle radiopacity. Prisma AP.H and Glacier differed (p<0.05) in relation to their accuracy to caries diagnosis, with Glacier having greater accuracy. There was a correlation between objective and subjective analyses with negative linear dependence. An increase in the material's radiopacity could have a subjectively negative influence on the diagnosis of secondary caries; thus, an ideal radiopacity for a dental composite is closer to the dentin image and produces similar attenuation to X-rays than does dentin.

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“…It was observed that radiographs taken with InSight ® film were cheap and accurate and that digital subtraction enhanced approximal enamel caries lesion detection (37).…”

Section: Detection Of Early Enamel Lesionmentioning

confidence: 99%

Early Enamel Lesion: Part I. – Classification and Detection

Kudiyirickal

Ivančaková

2008

Acta Med. (Hradec Kralove, Czech Repub.)

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There has been a paradigm shift from Black’s ‘extension for prevention’ to a minimal intervention approach in the recent time. The most important aspect in diagnosis of earliest stages of enamel demineralization involves accurate and reliable detection of such lesions. The newer diagnostic aids would enable the dentist to detect and diagnose early enamel lesions and direct appropriate preventive measures to promote remineralization and conservation of the tooth substance. A high level of caries experience necessitates preventive strategies which are more cost effective than surgical intervention and restorative procedures.

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Assessment of enamel demineralization using conventional, digital, and digitized radiography

Cited by 24 publications

References 16 publications

Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization

Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization

Influence of Radiopacity of Dental Composites on the Diagnosis of Secondary Caries: The Correlation Between Objective and Subjective Analyses

Early Enamel Lesion: Part I. – Classification and Detection

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