Correlation between Vista Cam, ICDAS-II, X-ray bitewings and cavity extent after lesion excavation: an in-vivo pilot study.

BACKGROUND: To correlate fluorescence-based camera (FC), visual inspection (ICDAS-II) and radiographic examination X-rays bitewings (BW) to the extent of caries after excavation. METHODS: The occlusal sites of 20 permanent first and second molars in 14 young adolescents (12±2 years old) were examined at 1st Observation Unit of Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome. All the enrolled patients were asked to provide with X-rays bitewing of the studied teeth. The assessment of ICDAS-II and FC was performed by a trained operator. Then a second blind operator removed the carious lesion and evaluated the cavity extent (depth, width, length) after caries removal with a calibrated probe. To correlate FC measurements with bitewing sensitivity, 10 dentists evaluated the presence/absence of caries on the X-rays. RESULTS: All the occlusal sites assessed by fluorescence camera, ranged from 1.7 to 2, indicating in all cases deep enamel lesions with possible extent to dentine with a mean of 1.7±0. In accordance, visual inspection by ICDAS-II showed scores of 3 and 4. By contrast, the radiographic documentation, i.e. bitewing X-rays, was evaluated in only 6 cases as presence of caries. The extent of the cavities was determined by three consecutive measurements: depth, width and length, with a mean of 3.5+1.73, 2.8+1.07 and 3.2+1.64 mm respectively. These results confirmed the agreement between FC and ICDAS-II for diagnosis of cavities with extent to enamel and dentine, while showed the low sensitivity of bitewings X-rays, in accordance with the existing evidence in Literature. Moreover, the results of this study for the first time provide information about the cavity extent after caries removal for the occlusal sites with ICDAS-II 3 and 4 scores and FC≥1.7. CONCLUSIONS: X-rays evaluation showed diagnostic accuracy in 6% of the sample. VistaCam measurement of 1.7 was correlated to a cavity with 3.5, 2.8 and 3.2 mm of depth, width and length.

Analysis of the root morphology of European anterior teeth.

Aim of this study was to investigate the gross anatomy of the root of European anterior teeth. A review of the dental literature shows that in the past the root morphology was investigated from the inner pulp chamber for endodontic therapies. In order to be admitted to the study, the teeth had to be undamaged. Each tooth was identified by a serial number and gauged by a millimeter tape (for the root length), a goniometer (for the root angle), and a millimeter gauge (for the root diameter). Furthermore, a statistical elaboration of the data was performed to underline the shape variations of the surface around the different sides of the root. At the end of the analysis, 12 parameters for each single-root tooth were described. The study highlights significant differences (p<0.01) only in two teeth of the maxillary arch (central incisor and canine) and in one tooth of the mandibular arch (central incisor). In both cases, the observed differences may be due to the sinuosity of the cement-enamel line. The Tables for each measured parameter were obtained for all examined classes of teeth, but a comparison with literature data was possible only for the "root length" parameter. This study can be considered innovative for the absence, in the scientific literature, of a statistical analysis of all parameters with the exception of the "root length". Moreover, it gives a detailed updating of the data relative to the European population creating a useful tool as well for surgical interventions during periodontal therapy (for example in the choice of the right ultrasonic handpiece) as for new CAD/CAM assisted implant manufacturing techniques.