Should Cavitation in Proximal Surfaces Be Reported in Cone Beam Computed Tomography Examination?

Aim: A clinical study was done to assess the clinical diagnostic accuracy of cone beam computed tomography (CBCT) in detecting proximal cavitated carious lesions in order to determine whether cavitation should be reported when a CBCT examination is available. Materials and Methods: 79 adjacent proxi...

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Veröffentlicht in:Caries research 2014-01, Vol.48 (3), p.208-213
Hauptverfasser: Sansare, K., Singh, D., Sontakke, S., Karjodkar, F., Saxena, V., Frydenberg, M., Wenzel, A.
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container_end_page 213
container_issue 3
container_start_page 208
container_title Caries research
container_volume 48
creator Sansare, K.
Singh, D.
Sontakke, S.
Karjodkar, F.
Saxena, V.
Frydenberg, M.
Wenzel, A.
description Aim: A clinical study was done to assess the clinical diagnostic accuracy of cone beam computed tomography (CBCT) in detecting proximal cavitated carious lesions in order to determine whether cavitation should be reported when a CBCT examination is available. Materials and Methods: 79 adjacent proximal surfaces without restorations in permanent teeth were examined. Patients suspected to have carious lesions after a visual clinical and a bitewing examination participated in a CBCT examination (Kodak 9000 3D, 5 × 3.7 cm field of view, voxel size 0.07 mm). Ethical approval and informed consent were obtained according to the Helsinki Declaration. Radiographic assessment recording lesions with or without cavitation was performed by two observers in bitewings and CBCT sections. Orthodontic separators were placed interdentally between two lesion-suspected surfaces. The separator was removed after 3 days and the surfaces recorded as cavitated (yes/no), i.e. validated clinically. Differences between the two radiographic modalities (sensitivity, specificity and overall accuracy) were estimated by analyzing the binary data in a generalized linear model. Results: For both observers, sensitivity was significantly higher for CBCT than for bitewings (average difference 33%, p < 0.001) while specificity was not significantly different between the methods (p = 0.19). The overall accuracy was also significantly higher for CBCT (p < 0.001). Conclusion: CBCT was more accurate in detecting cavitation in proximal surfaces than bitewing radiographs; therefore a CBCT examination performed for other clinical applications should also be assessed for proximal surface cavities in teeth without restorations, and when detected, this pathology must be part of the dentist's report.
doi_str_mv 10.1159/000354838
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Materials and Methods: 79 adjacent proximal surfaces without restorations in permanent teeth were examined. Patients suspected to have carious lesions after a visual clinical and a bitewing examination participated in a CBCT examination (Kodak 9000 3D, 5 × 3.7 cm field of view, voxel size 0.07 mm). Ethical approval and informed consent were obtained according to the Helsinki Declaration. Radiographic assessment recording lesions with or without cavitation was performed by two observers in bitewings and CBCT sections. Orthodontic separators were placed interdentally between two lesion-suspected surfaces. The separator was removed after 3 days and the surfaces recorded as cavitated (yes/no), i.e. validated clinically. Differences between the two radiographic modalities (sensitivity, specificity and overall accuracy) were estimated by analyzing the binary data in a generalized linear model. Results: For both observers, sensitivity was significantly higher for CBCT than for bitewings (average difference 33%, p &lt; 0.001) while specificity was not significantly different between the methods (p = 0.19). The overall accuracy was also significantly higher for CBCT (p &lt; 0.001). Conclusion: CBCT was more accurate in detecting cavitation in proximal surfaces than bitewing radiographs; therefore a CBCT examination performed for other clinical applications should also be assessed for proximal surface cavities in teeth without restorations, and when detected, this pathology must be part of the dentist's report.</description><identifier>ISSN: 0008-6568</identifier><identifier>EISSN: 1421-976X</identifier><identifier>DOI: 10.1159/000354838</identifier><identifier>PMID: 24481006</identifier><identifier>CODEN: CAREBK</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adolescent ; Adult ; Bicuspid - diagnostic imaging ; Bicuspid - pathology ; Cone-Beam Computed Tomography - standards ; Dental Caries - diagnosis ; Dental Caries - diagnostic imaging ; Dentistry ; Female ; Humans ; Image Processing, Computer-Assisted - standards ; Linear Models ; Male ; Middle Aged ; Molar - diagnostic imaging ; Molar - pathology ; Observer Variation ; Original Paper ; Physical Examination ; Radiography, Bitewing - methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tooth Crown - diagnostic imaging ; Tooth Crown - pathology ; Tooth Discoloration - diagnosis ; Young Adult</subject><ispartof>Caries research, 2014-01, Vol.48 (3), p.208-213</ispartof><rights>2014 S. Karger AG, Basel</rights><rights>Copyright (c) 2014 S. 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Results: For both observers, sensitivity was significantly higher for CBCT than for bitewings (average difference 33%, p &lt; 0.001) while specificity was not significantly different between the methods (p = 0.19). The overall accuracy was also significantly higher for CBCT (p &lt; 0.001). Conclusion: CBCT was more accurate in detecting cavitation in proximal surfaces than bitewing radiographs; therefore a CBCT examination performed for other clinical applications should also be assessed for proximal surface cavities in teeth without restorations, and when detected, this pathology must be part of the dentist's report.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>24481006</pmid><doi>10.1159/000354838</doi><tpages>6</tpages></addata></record>
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subjects Adolescent
Adult
Bicuspid - diagnostic imaging
Bicuspid - pathology
Cone-Beam Computed Tomography - standards
Dental Caries - diagnosis
Dental Caries - diagnostic imaging
Dentistry
Female
Humans
Image Processing, Computer-Assisted - standards
Linear Models
Male
Middle Aged
Molar - diagnostic imaging
Molar - pathology
Observer Variation
Original Paper
Physical Examination
Radiography, Bitewing - methods
Reproducibility of Results
Sensitivity and Specificity
Tooth Crown - diagnostic imaging
Tooth Crown - pathology
Tooth Discoloration - diagnosis
Young Adult
title Should Cavitation in Proximal Surfaces Be Reported in Cone Beam Computed Tomography Examination?
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