Zoellner Axel, Heuermann Max, Weber Hans-Peter, Gaengler Peter
Department of Prosthodontics, University of Witten/Herdecke, Witten, Germany.
J Prosthet Dent. 2002 Sep;88(3):314-9. doi: 10.1067/mpr.2002.128122.
The diagnostic value of radiographs for interproximal caries detection on nonrestored teeth is well investigated. However, little is known about the use of radiographs in the diagnosis of secondary caries localized at crown margins.
The aim of this study was to correlate clinical findings with regard to secondary caries with the findings of a radiographic evaluation.
One hundred randomly selected patients who underwent restorations with fixed prostheses and were exhibiting at least one secondary carious lesion were included in the study. A total of 820 restorations (test group, 730 interproximal surfaces of 365 single crowns and 910 interproximal surfaces of 455 fixed partial denture retainer crowns) and 1024 interproximal surfaces of 512 nonrestored teeth (control group) were investigated clinically, with the use of modified California Dental Association criteria, and radiographically for interproximal carious lesions. The extension of the lesions was rated to be initial (with no cavitation), early (with cavitation limited to orthodentin), or deep (with cavitation). The data were statistically analyzed for normal distribution, and the frequency of the findings was calculated in absolute numbers and as a percentage. Statistically significant differences were determined by use of the chi(2) test (P<.05). A linear regression model was applied for the correlation between the percentage of secondary caries and the duration of the crowns in situ.
Secondary caries was diagnosed clinically in 11.2% of 1640 interproximal surfaces but only in 8.3% radiographically. In contrast, the frequency of interproximal carious lesions diagnosed clinically in nonrestored teeth increased with the use of radiographs from 3.3% to 4.1%.
Within the limits of this study, the results confirm that radiographs improve the diagnostic sensitivity for interproximal caries in nonrestored teeth. However, for the diagnosis of secondary caries in crowned teeth, the clinical examination is more reliable than the radiographic evaluation.
X线片对未修复牙齿邻面龋检测的诊断价值已得到充分研究。然而，关于X线片在诊断牙冠边缘继发龋方面的应用却知之甚少。
本研究的目的是将继发龋的临床检查结果与X线片评估结果进行关联。
本研究纳入了100例随机选择的接受固定修复且至少有一处继发龋损的患者。共对820个修复体（试验组，365个单冠的730个邻面和455个固定局部义齿固位冠的910个邻面）以及512颗未修复牙齿的1024个邻面（对照组）进行了临床检查（采用改良的加利福尼亚牙科协会标准）和邻面龋损的X线片检查。将病损范围评定为初期（无龋洞）、早期（龋洞局限于正牙本质）或深度（有龋洞）。对数据进行正态分布的统计学分析，并以绝对数和百分比计算检查结果的频率。采用卡方检验确定统计学上的显著差异（P<0.05）。应用线性回归模型分析继发龋百分比与牙冠在位时间之间的相关性。
在1640个邻面中，临床诊断为继发龋的占11.2%，而X线片诊断的仅占8.3%。相比之下，未修复牙齿临床诊断的邻面龋损频率通过X线片检查从3.3%增加到了4.1%。
在本研究范围内，结果证实X线片提高了未修复牙齿邻面龋的诊断敏感性。然而，对于有冠牙齿继发龋的诊断，临床检查比X线片评估更可靠。
