A radiographic method for distinguishing noncavitated from cavitated proximal carious lesions. A proof of concept clinical trial

Douglas K. Benn, Ryan L. Cooper, Martha E. Nunn, Sherrie E. Edwards, Sonia M. Rocha-Sanchez

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalOral surgery, oral medicine, oral pathology and oral radiology
DOIs
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Dentistry (miscellaneous)
  • Radiology Nuclear Medicine and imaging

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