Rudolphy M P, van Amerongen J P, Penning C, ten Cate J M
Department of Cariology and Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands.
Caries Res. 1993;27(4):312-6. doi: 10.1159/000261557.
This investigation was carried out to establish the validity of bite-wing radiographs for the diagnosis of secondary caries in teeth with occlusal amalgam restorations. One hundred and fifty-nine extracted molars with occlusal amalgam fillings and characteristics that might be indicative of the presence of secondary caries were selected. The characteristics were a blueish-gray discolouration of enamel, a brownish discolouration of the amalgam-enamel margin, marginal breakdown of the restoration, and/or deep fissures at the margin of the restoration. The teeth were radiographed in a bucco-lingual direction to obtain images comparable to bite-wings. Subsequently, the crowns were sectioned (700 microns) and glued on plastic sheets. The sections were recorded radiographically and then examined by independent examiners. Radiolucencies as well as radiopacities adjacent to the restoration were considered to be caries. The validation of the bite-wing radiographic diagnosis was achieved by comparison with the radiographs of the sections. A sensitivity of 64% and a specificity of 98% were calculated. Large lesions were always visible on the bite-wing radiograph (100%), the majority of medium-sized lesions (89%) and 40% of small lesions. Small radiopacities were detected more often than small radiolucencies.
本研究旨在确定咬合翼片对诊断有咬合面汞合金修复体牙齿继发龋的有效性。选取了159颗有咬合面汞合金充填物且具有可能提示继发龋存在特征的拔除磨牙。这些特征包括牙釉质蓝灰色变色、汞合金-牙釉质边缘褐色变色、修复体边缘破损和/或修复体边缘深裂隙。将牙齿沿颊舌向进行X线摄影以获得与咬合翼片类似的图像。随后，将牙冠切片（700微米）并粘贴在塑料片上。对切片进行X线摄影记录，然后由独立检查者进行检查。修复体邻近区域的透射影以及阻射影均视为龋齿。通过与切片的X线片比较来验证咬合翼片X线诊断。计算得出敏感度为64%，特异度为98%。大的病变在咬合翼片X线片上总是可见（100%），大多数中等大小病变（89%）以及40%的小病变可见。小的阻射影比小的透射影更常被检测到。
