Diagnostic performance of cone-beam computed tomography on detection of mechanically-created artificial secondary caries

PURPOSE: The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. MATERIALS AND METHODS: One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve (Az) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). RESULTS: The mean Az values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest Az value. CONCLUSION: Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.

Oral Pemphigus Vulgaris

Pemphigus vulgaris (PV) is a chronic autoimmune intraepithelial vesiculobullous disease of the skin and mucous membranes. PV commonly affects the oral mucosa and it can be the initial site of presentation. Oral lesions present as painful ulcers preceded by bullae. The diagnosis of PV is based on clinical, histopathologic and immunopathologic examination. Systemic steroids are the mainstay of treatment for PV. This article reviews the etiology, pathogenesis, clinical presentations, diagnosis and management of PV.Key Words: pemphigus vulgaris, steroids

Oral Lesions and Dental Caries Status in Vertically HIV- Infected Children: an Epidemiological Survey at the Sanpathong Hospital, Chiang Mai

The objective of the cross-sectional study was to describe the prevalence of oral lesions and dental caries status in perinatally HIV-infected children who regularly visited the Sanpathong Hospital, Chiang Mai. Twenty-eight children with perinatal HIV infection, from 4 years and 9 months to 12 years of age, were included in this study. The children were examined for oral lesions and dental caries using modified WHO record forms. CD4 counts and history of receiving ART were also recorded. Samples of candidal culture were collected by oral swab. The results revealed that a total of 28.57% of the children had one or more lesions. Erythematous candidiasis was the most common oral lesion. By culture technique, yeasts were isolated from 16/28 (57.14 %) of the children. All children had a history of receiving ART for more than one year. Three children had CD4 counts less than 200 cells/ml while twenty-five children had CD4 count more than 200 cells/ml. The mean DMFT and DMFS scores were 2.07 and 3.32, respectively. The dft and dfs were 3 and 6.57, respectively. In conclusion, the prevalence of oral lesions appeared to be lower than that described in other studies in Northern Thailand. These findings suggest that the use of ART could lead to reduction in prevalence of HIV-associated oral lesions. Furthermore, appropriate care for oral lesions and dental caries was needed for HIV-infected children in Northern Thailand.Keywords: HIV, children, oral lesions, dental caries status, candidiasis, CD4

Oral Discoid Lupus Erythematosus

Discoid lupus erythematosus (DLE) is a chronic autoimmune disorder of unknown etiology. DLE can affect the skin and oral mucosa. Classic discoid rashes are frequently found on the sunlight- exposed skin, especially on the face and scalp. Oral lesions are characterized by erythematous plaques, erosions, or ulcers with radiating delicate white striae. The buccal mucosa and lip are most frequently affected. The diagnosis of oral DLE is based on clinical, histopathological and immunopathological examination. Oral lesions can be treated with topical steroids. This article reviews the etiology, clinical presentations, diagnosis and management of oral DLE.Keywords: discoid lupus erythematosus, topical steroids