Estimation of remaining dentine thickness below deep lesions of caries

Lancaster, P. E.; Craddock, Helen L; Carmichael, Fiona

doi:10.1038/sj.bdj.2011.965

Cited by 19 publications

(18 citation statements)

References 25 publications

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“…Similar to Jesse et al 28 and Kooistra et al, 29 we consider the measurement of RDT on histological sections to be the reference (gold standard). Nonetheless, our results differ from theirs and from the results of other authors, such as Lancaster et al 7 However, they corroborate those of Mejare and Kidd, 30 who found an overestimation of the depth of the lesion on the radiograph, which is due to the projection of the periphery of the carious lesion on the bottom of the latter.…”

Section: Discussioncontrasting

confidence: 55%

“… 33 Moreover, this meets the principle of “stepwise excavation” that is currently widely accepted in the restoration of deep carious lesions and is performed since many years, on primary teeth 34 ; one of the main objectives of our study was to assess the RDT, thus allowing us to establish the most appropriate therapeutic indication. 7 …”

Section: Discussionmentioning

confidence: 99%

“…5 6 Furthermore, radiographs are also ambiguous when it comes to precise measurement of the RDT in deep cavities. 7 …”

Section: Introductionmentioning

confidence: 99%

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Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars

Berbari

Khairallah

Kazan

et al. 2018

International Journal of Clinical Pediatric Dentistry

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AimThis study was carried out to assess the reliability of measurements of the remaining dentin thickness under deep carious lesions as estimated from digital radiographs. The goal is to allow clinicians to correlate the radiographic measurement to the exact value of the remaining dentin thickness. The results obtained will be tested further in a study that will evaluate the histopathologic pulpal state according to the caries’ lesion depth.Materials and methodsThe study was conducted in the Pediatric Dentistry Department at the Lebanese University, in collaboration with the research platform of the same university. Fifty deciduous molars with deep caries on proximal surfaces liable to extraction were collected. Before extraction, a digital in vivo periapical radiograph was taken, followed by manual excavation of the caries. After excavation, another radiograph was taken before the tooth was sectioned through the deepest site of the lesion. Another radiograph was then obtained for each tooth fragment. To evaluate the exact thickness of the remaining dentin, each fragment was measured on a histologic macropho-tograph. The measurements were then compared statistically using a paired-samples t-test, and a correlation was sought.ResultsNo significant difference was observed in the radiographs between the measurement of the remaining dentin thickness before and after the excavation of caries. In contrast, the radiographic measurements of remaining dentin thickness were underestimated by an average of 20% compared with those made with macrophotographs.LimitationsInterpretation of radiographs varies from one practitioner to another and is a function of the operator’s visual acuity.ConclusionMeasuring the residual dentin thickness on a radiograph underestimates the actual thickness by about 20%. Further studies are needed to confirm these results.Clinical significanceOur results indicate that remaining dentin thickness is greater in reality than is shown on a radiograph. This information can help clinicians to refine their diagnoses and treatment plans.How to cite this article: Berbari R, Khairallah A, Kazan HF, Ezzedine M, Bandon D, Sfeir E. Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars. Int J Clin Pediatr Dent 2018;11(1):23-28.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars

Berbari

Khairallah

Kazan

et al. 2018

International Journal of Clinical Pediatric Dentistry

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“…On the other hand, dental radiographs seem to exhibit low sensitivity but rather high specificity, whereas the true RDT and extent of caries lesions seem to be underestimated (3,4). SS-OCT showed significantly higher sensitivity and larger area under the receiver operating characteristic curve than radiographs for the characterization of cavitated enamel lesions and dentin caries when compared with bitewing radiographs (19).…”

Section: Discussionmentioning

confidence: 98%

“…Usually radiographs are taken for the diagnosis and to see the extension of the caries. Radiographs may help to identify either new or recurrent caries but can only roughly assess the remaining dentin thickness (RDT) and pulp horns to avoid the exposure of the vital pulp tissue (3). Moreover, because radiography produces harmful x-rays and superimposition of the structures results in limited diagnostic accuracy, it is not a convenient option at the time of treatment (4).…”

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confidence: 99%