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2014 ; 43
(7
): 20130342
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The influence of amalgam fillings on the detection of approximal caries by cone
beam CT: in vitro study
#MMPMID24986630
Kulczyk T
; Dyszkiewicz Konwi?ska M
; Owecka M
; Krzy?ostaniak J
; Surdacka A
Dentomaxillofac Radiol
2014[]; 43
(7
): 20130342
PMID24986630
show ga
OBJECTIVES: The aim of this CBCT investigation on the detection of caries was to
assess the influence of artefacts produced by the presence of amalgam fillings
located in the vicinity. METHODS: 102 non-cavitated pre-molar and molar teeth
were placed in blocks of silicone with approximal contacts consisting of 3 sound
or carious teeth and 1 mesial-occlusal-distal amalgam-filled tooth in-between.
Radiographs of all the teeth were recorded using the CBCT system (NewTom? 3G; QR
Srl, Verona, Italy; field of view, 9 inches). Data from the CBCT unit were
reconstructed and sectioned in the mesiodistal tooth plane. Images were evaluated
twice by two observers, using a five-step confidence scale. After the CBCT
examination, the teeth were individually sectioned in the mesiodistal direction
with a diamond saw. Using a light microscope at ×40 magnification, the true
morphological status of all approximal surfaces was established. RESULTS:
Sensitivity of the CBCT for the detection of caries on surfaces located
proximally and distally to an amalgam filing ranged from 0.27 to 0.30 for enamel
and from 0.47 to 0.56 for dentin. Specificity values for enamel proximal and
distal lesions were 0.48 and 0.53, respectively, for enamel and 0.33 to 0.38,
respectively, for proximal and distal dentin cases. Intra-observer reliability
was 0.84, and interobserver reliability was 0.49. CONCLUSIONS: Owing to its low
specificity, scans from a CBCT examination should not be used to determine the
presence of demineralization of the tooth surface when amalgam fillings are
present in the region of interest.