ABSTRACT
STATEMENT OF THE PROBLEM: Presently, various imaging methods are available for the disclosure of proximal caries. Some recent studies have attempted to determine the diagnostic accuracy of available modalities, but they have shown variable results. Aim: This study was carried out to recognize and examine the correctness of cone-beam computed tomography (CBCT), regular radiographs and the nondirect digital system in the disclosure of interproximal caries. Materials and Method: In this observational tryout study, forty-two extracted non-cavitated, unrestored person molar and premolar teeth were placed in the blocks with proximal surfaces in touch. Then they were appraised by CBCT, formal radiographs and the nondirect digital system for the disclosure of interproximal caries. Four oral and maxillofacial radiologists used a 4-point scale to assess the pictures for the existence or absence of proximal caries. Caries depth was specified by histological examination. The gathered data were assessed by SPSS software using Weighted Kappa and Friedman test. Results: Statistics demonstrated that the accuracy of the indirect digital system was somewhat better than conventional systems. The accuracy of the indirect digital system was better than cone beam system, and this difference was statistically significant. Conclusion: The digital system was better than CBCT in the disclosure of proximal caries. The formal radiography fell in between the two other systems without a statistically significant deviation in detecting caries. Thus, CBCT is not advised to detect proximal caries because of the higher radiation dose.
ABSTRACT
Background: This study evaluated and determined the proximity of an impacted third mandibular molar (TMM) to the inferior alveolar canal (IAC) by using CBCT and digital panoramic radiography. Materials and Methods: This descriptive-analytic research applied CBCT and panoramic radiographs for 60 subjects (28 men, 32 women). Subjects selected showed a close proximity about the TMM to the inferior nerve canal on panoramic radiographs; these subjects then received CBCT radiographs. The CBCT findings for the proximity of the TMM to inferior nerve canal used the outcomes of surgical findings as the standard of comparison. Results: Eight cases showed positive surgical findings indicating vicinity of the third molar and the mandibular nerve canal. Only 13.3% of the cases in which panoramic views showed the proximity of the TMM and the IAC were confirmed during surgery. The result for CBCT radiographic diagnosis was 95%. Conclusion: It can be concluded that CBCT is preferred over panoramic radiography to determine the proximity of the impacted TMM to the IAC. Narrowing of the mandibular canal or root canal, disconnection of root borders in panoramic radiography, and the inferior-lingual proximity of the tooth to the root in CBCT strongly indicated the close nearness of the impacted TMM to the IAC.
ABSTRACT
BACKGROUND: Pulpotomy is one of the most commonly used treatments for retaining pulpally involved primary molar teeth in order to prevent tooth extraction and maintain space within the jaws. A recent randomised clinical trial found that calcium enriched mixture (CEM) cement demonstrated favourable 2-year treatment outcomes for pulpotomy of carious primary molars comparable with mineral trioxide aggregate (MTA). The use of cone beam computer tomography (CBCT) has not previously been used to evaluate pulpotomy and histological outcomes. CASE REPORT: A coronal pulpotomy was performed on a carious maxillary first primary molar in a 7-year-old child with non-contributory medical history. Following haemostasis, the radicular pulp was covered with 2-3 mm of CEM and the tooth restored. FOLLOW-UP: At the 2-year follow-up appointment, clinical/radiographic examinations of the pulpotomised tooth revealed that vital pulp therapy was successful in maintaining the tooth asymptomatic; however, the first maxillary molars had to be extracted for orthodontic reasons. CBCT and histological examinations showed thick/complete calcific bridges with tubular dentine at the amputation sites. The underlying dental pulp had normal structure and was un-inflamed. CONCLUSION: Based on these findings, it seems that CEM cement can induce a favourable biological response in dental pulps of primary teeth and CBCT may be useful to evaluate pulpotomy outcomes.
