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Christian hEllEn rodriguEs da Cunha Mestrando em Clínicas Odontológicas-ênfase em Radiologia Odontológica e Imaginologia da PUC-MINAS. luCiano andrEi FranCio Mestrando em Clínicas Odontológicas-ênfase em Radiologia Odontológica e Imaginologia da PUC-MINAS.

This article describes the clinical case of an 86-year-old female patient with an asymptomatic clinical condition, without presenting a history of previous traumatisms. When routine radiographic exam-panoramic radiograph-was performed, the following extensions of the paranasal sinuses were found: maxillary sinus (palate), sphenoid sinus (pterygoid process, major wing, and anterior clinoid process), and supraorbital portion of the frontal sinus. Thus computerized tomography was performed to confirm the diagnosis.

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PurposeThe present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT).Materials and MethodsForty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient.ResultsFor bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations (P>.05), but showed no discriminatory ability for amalgam restorations (P<.05).ConclusionBitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.