Accuracy of proximal caries depth determination using two intraoral film speeds.

Bite-wing radiographs are an integral part of a thorough diagnostic evaluation for interproximal caries. This study evaluates the observers' ability to assess correctly proximal carious lesion depth with two different speeds of intraoral film. Significant underestimation of lesion depths by the observers with both imaging modalities are shown, with no significant diagnostic difference between the two film types for both the presence and extent of caries.

Radiographic analysis of regenerated bone around endosseous implants in the canine using recombinant human bone morphogenetic protein-2.

Ideal endosseous implant placement involves a congruent bony housing in close apposition to the implant surface. Clinical situations are encountered, however, in which the entire implant surface cannot be in close apposition to bone. In these instances, bone grafting materials are generally used to regenerate bone around the implant. In this study, a biologically active bone differentiation factor, recombinant human bone morphogenetic protein-2 (rhBMP-2), was used with two different carriers to regenerate bone around implants in standardized critical-sized defects in the canine mandible. Half of the sites had a nonresorbable membrane placed over the defect. Longitudinal standardized radiographs were obtained to assess the amount of bone regeneration on the mesial and distal of the implants after 4 and 12 weeks of healing. Ninety-six implants were placed in 12 fox-hounds. Bone fill was determined by linear measurement of bone on the radiographs, and changes in bone density were evaluated by computer-assisted densitometric image analysis of discrete areas adjacent to the implant. After 4 weeks of healing, nonmembrane sites had significantly greater bone height than membrane-protected sites. Following 12 weeks of healing, sites treated with rhBMP-2 had significantly greater bone formation than untreated sites. Sites treated with rhBMP-2 and a membrane had the greatest bone fill, followed by sites treated with rhBMP-2 but no membrane. Sites without rhBMP-2, whether with or without a membrane, had less bone fill than sites with rhBMP-2. At 12 weeks, sites with a membrane resulted in significantly more gain in bone density than sites without a membrane. Furthermore, sites treated with a collagen carrier resulted in greater gains in bone density than sites treated with a polylactide/glycolide carrier. The results from this study demonstrate by radiographic evidence that new bone formation in critical-sized defects around implants is dependent on time after defect treatment, the type of carrier used, the use of a barrier membrane, and the presence of rhBMP-2. In addition, these findings suggest that rhBMP-2, a bone differentiation factor, can significantly stimulate bone formation around endosseous dental implants.

Evaluation of an endosseous titanium implant with a sandblasted and acid-etched surface in the canine mandible: radiographic results.

Previous studies have demonstrated in short-term experiments that sandblasted and acid-etched (SLA) titanium implant had a greater bone-to-implant contact than a titanium plasma-sprayed (TPS) implant in non-oral bone. In the present study, an SLA implant was compared radiographically to a TPS implant under unloaded and loaded conditions in the canine mandible for up to 15 months. 69 implants were placed in 6 foxhounds. Standardized radiographs were taken at baseline, preload, 3, 6, 9, and 12 months of loading. Loaded implants were restored with gold crowns similar to the natural dentition. Radiographic assessment of the bone response to the implants was carried out by measuring the distance between the implant shoulder and the most coronal bone-to-implant contact (DIB) and by evaluated of bone density changes using computer-assisted densitometric image analysis (CADIA). 5 different areas-of-interest (AOI) were defined coronally and apically along the implant. DIB measurements revealed that SLA implants had significantly less bone height loss (0.52 mm) than TPS implants (0.69 mm) at the preload evaluation (p = 0.0142) as well as at 3 months of loading (0.73 mm/1.06 mm; p = 0.0337). This difference was maintained between the implant types during the 1-year follow-up period. The same trend was also evident for CADIA measurements with SLA implants showing higher crestal bone density values when comparing preload to baseline data (p = 0.0890) and 3 months to baseline data (p = 0.0912). No measurable bone density changes were apparent in the apical areas of either implant. These results suggest that SLA implants are superior to TPS implants as measured radiographically in oral bone under unloaded and loaded conditions.