Imaging Sci Dent.  2018 Jun;48(2):87-95. 10.5624/isd.2018.48.2.87.

Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth

• Francio LA
• Silva FE
• Valerio CS
• Cardoso CA
• Jansen WC
• Manzi FR

• KMID: 2413919
• DOI: http://doi.org/10.5624/isd.2018.48.2.87

Abstract

PURPOSE
The 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 METHODS
Forty 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.
RESULTS
For 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).
CONCLUSION
Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.

Keyword

Biomedical and Dental Materials; Cone-beam Computed Tomography; Digital Radiography; X-ray diagnosis

MeSH Terms

Biomedical and Dental Materials
Cone-Beam Computed Tomography
Dental Amalgam
Humans
Methods*
Microscopy
Molar
Radiographic Image Enhancement
Radiography
ROC Curve
Tooth*
Biomedical and Dental Materials
Dental Amalgam

Figure

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  Fig. 1 Tooth preparation. A. Selected tooth. B. Coronal section. C. Occlusal surface flattening. D. Finished class I cavity. E. Composite resin restoration. F. Amalgam restoration.

• 

  Fig. 2 A and B. Manikin positioned in an acrylic box, with a 15-mm-thick acrylic plate put in place in order to simulate the soft tissue.

• 

  Fig. 3 Image acquisition with different imaging methods. A. Conventional bitewing. B. Digital charge-coupled device (CCD) bitewing. C. Digital photostimulable phosphor plate (PSP), interproximal radiograph. D. Conventional panoramic radiograph. E. Digital panoramic radiograph. F. Cone-beam computed tomograph (CBCT).

• 

  Fig. 4 X-ray and tomographic images. A. Digital charge-coupled device (CCD) bitewing. B. Digital photostimulable phosphor plate (PSP) bitewing. C. Conventional bitewing. D. Conventional panoramic radiograph. E. Digital panoramic radiograph. F. Cone-beam computed tomography (CBCT).

• 

  Fig. 5 Histological sections. A. Tooth from the R1 group (composite resin restoration). B. Tooth from the R2 group (composite resin restoration with liner material). C. Tooth from the A1 group (dental amalgam restoration). D. Tooth from the A2 group (dental amalgam restoration with liner material).

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  Fig. 6 The receiver operating characteristic (ROC) curves for the evaluation of resin and amalgam restoration images obtained using various imaging methods. A. Conventional bitewing. B. digital photostimulable phosphor plate (PSP) bitewing. C. digital charge-coupled device (CCD) bitewing. D. Digital panoramic radiography. E. Conventional panoramic radiography.

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  Fig. 7 Receiver operating characteristic (ROC) curve of cone-beam computed tomography (CBCT) images for the evaluation of resin (A) and amalgam (B) restorations.

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