TY - JOUR
T1 - A radiographic method for distinguishing noncavitated from cavitated proximal carious lesions. A proof of concept clinical trial
AU - Benn, Douglas K.
AU - Cooper, Ryan L.
AU - Nunn, Martha E.
AU - Edwards, Sherrie E.
AU - Rocha-Sanchez, Sonia M.
N1 - Funding Information:
This work was supported by the National Institute of Dental and Craniofacial Research SSTR Phase I R41DE023003-01, STTR Phase II No. R41DE023003-02 and Nebraska Department of Economic Development No. 14-01-064. The agencies had no role in the study design, collection, analysis, interpretation of data or in writing this publication.
Funding Information:
We are grateful to Dr. Douglas Yoon, XDR Radiology, Los Angeles, California, who suggested the use of proximal boxes to access the study tooth surfaces, and Dennis R. Higginbotham, DDS, Stuart J. McNally, DDS, Carol M. Murdock, DDS, and Raymond S. Shaddy, DDS, of the Department of Operative Dentistry, Creighton University, who greatly assisted this work by screening the student patients for the clinical trial. On a personal note (DKB), I thank my co-workers Oliver Benn (son) and Pete Steinhausen, who provided guidance and encouragement through a long and tortuous journey.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021
Y1 - 2021
N2 - Objectives: We propose a new topical radiographic contrast method for distinguishing noncavitated from cavitated radiolucencies. Laboratory tests and a pilot clinical trial were designed to test the feasibility and efficacy of the method. Study Design: Twenty-two adults with 27 proximal radiolucencies had conventional bitewing (BW) examinations. After exclusion, 21 surfaces were evaluated. A concentrated solution of sodium iodide was placed in the interdental spaces via a microsyringe and BWs were again exposed. A class II cavity preparation was made in the adjacent tooth and polysiloxane impressions were made of the study surfaces. The impressions were scanned by visible light, creating a high resolution 3D replica. Cavitations, if present, were measured. Results: Nine surfaces were noncavitated and 12 surfaces were cavitated. The microsyringe dispensed a variable volume of liquid, which affected the accuracy of the test. The sensitivity for cavitation was 50%, specificity was 88.9%, and accuracy was 66.7%. This compares to a reported 60% sensitivity, 62% specificity, and 62% accuracy for BW examinations. Intraexaminer reliability for classifying noncavitated or cavitated lesions using the kappa test was 0.649. Conclusions: This method needs improvement but was an advance over conventional BWs and could result in reduction of restorations in low- and high-risk patients.
AB - Objectives: We propose a new topical radiographic contrast method for distinguishing noncavitated from cavitated radiolucencies. Laboratory tests and a pilot clinical trial were designed to test the feasibility and efficacy of the method. Study Design: Twenty-two adults with 27 proximal radiolucencies had conventional bitewing (BW) examinations. After exclusion, 21 surfaces were evaluated. A concentrated solution of sodium iodide was placed in the interdental spaces via a microsyringe and BWs were again exposed. A class II cavity preparation was made in the adjacent tooth and polysiloxane impressions were made of the study surfaces. The impressions were scanned by visible light, creating a high resolution 3D replica. Cavitations, if present, were measured. Results: Nine surfaces were noncavitated and 12 surfaces were cavitated. The microsyringe dispensed a variable volume of liquid, which affected the accuracy of the test. The sensitivity for cavitation was 50%, specificity was 88.9%, and accuracy was 66.7%. This compares to a reported 60% sensitivity, 62% specificity, and 62% accuracy for BW examinations. Intraexaminer reliability for classifying noncavitated or cavitated lesions using the kappa test was 0.649. Conclusions: This method needs improvement but was an advance over conventional BWs and could result in reduction of restorations in low- and high-risk patients.
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U2 - 10.1016/j.oooo.2021.02.014
DO - 10.1016/j.oooo.2021.02.014
M3 - Article
AN - SCOPUS:85107429597
JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
JF - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
SN - 2212-4403
ER -