Department of General Dental Practice, Faculty of Dentistry, Health Sciences Centre, Kuwait University, Jabryia, Kuwait.
Department of Diagnostic Sciences, Faculty of Dentistry, Health Sciences Centre, Kuwait University, Jabryia, Kuwait.
J Dent. 2022 Jul;122:104145. doi: 10.1016/j.jdent.2022.104145. Epub 2022 May 3.
The aim of this study was to evaluate the use of digital bitewing radiographs using photostimulable phosphor (PSP) plates in the estimation of the true extension of proximal carious lesions.
The sample size was calculated to be 70 teeth. Adult patients with a minimum of one posterior tooth with primary proximal caries lesions were included. A preoperative bitewing radiograph was taken and the extension of the carious lesion was measured from the most prominent point on the adjacent sound tooth to the deepest axial point of the lesion. An experienced general dentist provided the restorative treatment and made a polyvinyl siloxane impression of the cavity preparation. Clinical caries extension was measured from the most prominent point of the adjacent tooth until the deepest boundary of the axial wall of the preparation on the impression. Postoperative radiographs were taken at the completion of restorative care. The bitewing radiographs were done using PSP plates and caries extension measurements were performed using measuring tools of the digital radiography software. Pairwise comparisons were made between preoperative and postoperative radiographs, and the true clinical depth measurements using paired t-tests.
In total, 73 teeth from 44 subjects were included. A significant difference of 0.82 mm was found between preoperative radiographs and clinical measurements (p<0.001). Similarly, comparisons between preoperative and postoperative radiographic measurements showed significant differences of 0.99 mm (p<0.001).
The study found that the true clinical extension of proximal caries after non-selective caries removal was significantly deeper than the preoperative radiographic extension assessment. This was not influenced by the tooth type, the location of the tooth, or the affected tooth surfaces.
When a non-selective caries removal strategy is adopted, clinicians should be aware that PSP bitewing radiographs underestimate the true clinical extension of proximal caries lesions. This will have an impact on clinicians' practice and restorative treatment decisions.
本研究旨在评估使用光激励磷光（PSP）板的数字化牙合翼片在估计近中龋病变真实扩展范围中的应用。
样本量计算为 70 颗牙。纳入至少有一颗后牙存在原发性近中龋病变的成年患者。拍摄术前牙合翼片，从相邻正常牙最突出点到病变最深的轴向点测量龋损的扩展范围。一位经验丰富的全科牙医提供修复治疗，并对牙体预备进行聚硅氧烷印模。临床龋损扩展范围从相邻牙齿的最突出点测量到预备轴壁的最深边界。在完成修复治疗后拍摄术后牙合翼片。使用 PSP 板进行牙合翼片拍摄，并使用数字放射成像软件的测量工具进行龋损扩展测量。对术前和术后的牙合翼片进行两两比较，并使用配对 t 检验对真实临床深度测量进行比较。
共有 44 名患者的 73 颗牙齿纳入研究。术前牙合翼片和临床测量值之间存在 0.82 毫米的显著差异（p<0.001）。同样，术前和术后放射学测量值之间的比较显示存在 0.99 毫米的显著差异（p<0.001）。
本研究发现，非选择性龋损去除后近中龋的真实临床扩展范围明显深于术前放射学评估。这不受牙齿类型、牙齿位置或受影响的牙面影响。
当采用非选择性龋损去除策略时，临床医生应意识到 PSP 牙合翼片低估了近中龋病变的真实临床扩展范围。这将对临床医生的实践和修复治疗决策产生影响。
