Comparison of the Accuracy of Digital Radiography with Conventional Radiography and Visual Examination in the Detection of Permanent Teeth Interproximal Caries

Objective: To compared the accuracy of digital radiography in the diagnosis of interproximal caries in permanent teeth with conventional radiography and visual examination. Material and Methods: In this descriptive-analytical study, 78 human premolars, which seem normal in primary examination, are mounted on the plaster in a pair-wise manner and their caries are visually evaluated. Conventional and digital radiographic images are taken under the same conditions and their caries are graded with Confidence Score. To determine the golden standard, after mesiodistal incision, the teeth are examined using stereomicroscopy. Finally, the results obtained by visual observation and conventional radiography as well as digital images were compared with those obtained from the stereomicroscopy to determine their accuracy in detecting the interproximal caries. Results: The consistencies between the visual, digital, and conventional methods with the standard method (microscopic histology) are 53%, 78%, and 50% respectively - all of them are significant (p<0.05). The highest and the lowest sensitivities are related to the digital (96%) and visual (88%) methods respectively, while the highest and lowest specificities are related to the digital (79%) and conventional (50%) methods respectively. The highest and lowest positive predictive value is related to the digital (79%) and conventional (80%) methods respectively. The highest and lowest negative predictive values are related to the digital (90%) and visual (71%) methods respectively. Compared with the standard methodology, the most accurate diagnostic accuracy can be seen for the digital method (91%). Conclusion: There is no significant difference in the diagnosis of interproximal caries by different methods, and the only advantage of digital radiography, compared with the conventional one, is storing radiographs without losing important information and the lower dose of radiation for the patient.

Radiographic Bone Evaluation after Periodontal Full Mouth Disinfection Treatment in Women Undergoing Chemotherapy or Hormone Therapy with Tamoxifen

Objective: To radiographically evaluate the alveolar bone level after periodontal full mouth disinfection (FMD) treatment in women during chemotherapy (CHE) and hormone therapy with Tamoxifen (TAM). Material and Methods: This is an uncontrolled clinical trial with a convenience sample of women in antineoplastic treatment (CHE and TAM) and non-surgical periodontal FMD treatment. The Radiographic examination consisted of four bitewing radiographs and six periapical radiographs of the upper and lower anterior teeth, acquired according to the parallelling standard technique at three times: before (T0), 3 (T3) and 6 (T6) months after periodontal treatment. The alveolar crest level in the interproximal area of each tooth was measured by two calibrated observer using magnifying glass and digital caliper. Statistical analysis was performed for evaluation of the three times in each experimental group using the Friedman test (p < 0.05) and between groups, the Mann Whitney test (p <0.05). Results: Overall, 14 women undergoing treatment for breast cancer participated in this study. A follow-up loss of five (35.71%) women occurred during the study and the final sample size was composed of nine women divided into two groups: CHE (n = 4) and TAM (n = 5). A total of 330 sites were evaluated: 126 (CHE) and 204 (TAM). The alveolar bone level showed statistically significant reduction after 6 months of FMD therapy (p <0.05), but there was no difference between antineoplastic treatment type (p> 0.05). Conclusion: Patients undergoing chemotherapy and hormone therapy with Tamoxifen showed better alveolar bone levels after six months of periodontal FMD treatment. The current antineoplasic therapy did not influence the results obtained with periodontal treatment.

Evaluation of therapeutic decision for treatment of carious lesions by dental students

Objective: to evaluate the therapeutic decision making for the academic of the last year of dentistry at the universities of the Distrito Federal, on dental caries in deciduous teeth and permanent young. Material and Methods: the evaluation was obtained through the application of a questionnaire containing a diagram representing five different stages of deep carious lesions on interproximal radiographs. Were selected through census of students enrolled last semester of each institution and concluded that the theoretical discipline of pediatric dentistry in accordance with the curriculum offered by the University. Data were analyzed statistically by the chi-square test the 5% level of significance. Results: we analyzed 132 questionnaires of which 30.3% of respondents opted for immediate restorative treatment for the injuries to deciduous teeth in the dentin-enamel junction to the permanent tooth, the percentage rose to 31.1%, revealing that there was similarity between universities about which strategy to use. Regarding caries removal there was a discrepancy in an institution compared the other in choosing the more invasive treatment (p = 0.0014). Conclusion: we see the need to implement teaching strategies for the training of a professional within the philosophy of minimum intervention.

Effect of X-ray beam vertical angulation on radiographic assessment of alveolar crest level.

Periodontal diseases are diagnosed and monitored by various methods. Probing pocket depth measurements and dental radiographs are two of the most commonly used methods. The aim of this study was to assess the effect of x-ray beam vertical angulation on radiographic assessment of alveolar crest level in five human mandibles. A standardized technique was used to take bitewing radiographs with -10 degrees, 0 degree and +10 degrees angulation of X-Ray beam. The range of the mean differences at individual sites was from 1.84 mm (0.58 +/- SD) to 3.70 mm (1.01 +/- SD). It was found that there was a wide range of over or underestimation of the alveolar crest level due to a change in beam angulation. It was concluded that, to monitor patients with periodontal disease or treatment outcomes, it is important to have reproducible images and bitewing film holders should be used to minimize the X-Ray beam angulation error in general dental practice.