Clinical and Radiological Evaluation of Secondary Caries in Crowned Teeth

Abstract

The aim of this study was to evaluate theresults of visual assessment of teeth restored withcrowns or fixed partial dentures with the outcomeof the radiographic evaluation and evaluate theinter observer agreement.Ninety three randomly selected patients whounderwent restorations with fixed prostheses wereincluded in the study. A total of 372 restorations 228 interproximal surfaces of 114 single crownsand 516 interproximal surfaces of 258 fixed partialdenture retainer crowns were investigated by twoobservers clinically, with the use of the criteriamodified by Zoellner et al, and radiographically forinterproximal carious lesions. The extension of thelesions was rated to be initial with no cavitation ,early with cavitation limited to orthodentin , ordeep with cavitation . Statistically significant differences were determined by use of the Pearson’schi square test P

Keywords

• Secondary caries, observer agreement, panoramic radiography, bitewing radiography

KRON-KÖPRÜ RESTORASYONLARINDA SEKONDER ÇÜRÜĞÜN RADYOLOJİK VE KLİNİK OLARAK DEĞERLENDİRİLMESİ

Abstract

Amaç: Bu çalışmanın amacı, özellikle serbestdişhekimliği uygulamalarında kron-köprürestorasyonları olan dişlerde sekonder çürüğündeğerlendirilmesinde sık başvurulan bir yöntemolan panoramik radyografinin, bitewing radyografinin ve klinik muayene verilerinin sekonderçürük teşhisindeki etkinliğinin araştırılması vegözlemciler arası uyumun değerlendirilmesidir. Çalışma grubunu kron-köprü restorasyonunasahip 93 hasta oluşturmaktadır. Çalışmada 114adet tek kron ve 258 adet köprü ayağı olmak üzere372 posterior dişe ait 744 ara yüz sekonder çürükaçısından iki gözlemci tarafından klinik ve radyolojik olarak değerlendirilmiştir. Hastaların DMFT veDMFS indeksleri, kron ve/veya köprü restorasyonları; restorasyonun tipi, cinsi ve ağızda kalmasürelerine göre kaydedilmiştir. Çürük lezyonlarınınsınıflandırılmasında başlangıç, erken ve derinçürük lezyonlarını tanımlayan morfolojik karakteristiklere dayalı Zoellner ve arkadaşlarının modifiye ettiği sekonder çürük kriterleri kullanılmıştır.İstatistiksel farklılıklar Pearson ki kare testi P

Keywords

• Sekonder çürük, gözlemciuyumu, panoramik radyografi, bitewing radyografi

References

1. Valderhaug J, Joksad A, Ambjorsen E, Norheim PW. Assessment of the periapical and cli- nical status of crowned teeth over 25 years. J Dent 1997;25:97-105.
2. Nevalainen MJ, Narhi TO, Siukosaari P, Schimidt-Kaunisaho K, Ainamo A. Prosthetic reha- bilitation in the elderly inhabitants of Helsinki, Finland. J Oral Rehabil 1996;23:722-8.
3. White BA, Albertini TF, Brown LJ, Larach- Robinson D, Redford M, Selwitz RH. Selected tooth restoration and conditions: United States, 1988- 1991. J Dent Res 1996;75:661-71.
4. Lindquist E, Karlsson S. Success rate fai- lures for fixed partial dentures after 20 years of ser- vice: Part I. Int Prosthodont 1998;11:133-8.
5. Walton TR. A 10-year longitudinal study of fixed prosthodontics: Clinical characteristics and outcome of single-unit metal-ceramic crowns. Int Prosthodont 1999;12:519-26.
6. Glantz PO, Ryge G, Jendresen MD, Nilner K. Quality of extensive fixed prosthodontics after five years. J Prosthet Dent 1984; 52:475-9.
7. Glantz PO. Clinical longevity of crown-and- bridge protheses. InAnusavice KJ (ed). Quality eva- luation of dental restorations: Criteria for placement and replacement. Chicago: Quintessence, 1989:343- 54.
8. Schwartz NL, Whitsett LD, berry TG, Steward JL. Unserviceable crowns and fixed partial dentures: Life span and causes for loss of service- ability. JADA 1970;81:1395-401.

9. Leempoel PJB, Eschen S, De haan AFJ. An evaluation of crowns and bridges in general dental practice. J Oral Rehabil 1985;12:515-28.
10. Lussi A. Validity of diagnostic and treat- ment decisions of fissure caries. Caries Res 1991;25:296-303.
11. Lussi A. Comparison of different methods for the diagnosis of fissure caries without cavitation. Caries Res 1993;27:409-16.
12. Mejare I, Grondahl HG, Carlstedt K, Grever AC, Ottosson E. Accuracy at radiography and pro- bing for the diagnosis of proximal caries. Scand J Dent Res 1985;93:178-84.
13. Penning C, van Amerongen JP, Seef RE, ten Cate JM. Validity of probing for fissure caries diag- nosis. Caries Res 1992;26:445-9.
14. Yassin OM. In vitro studies of the effect of a dental explorer on the formation of an artificial ca- rious lesion. ASDC J Dent Child 1995;62:111-7.
15. Zoellner A, Bragger U, Fellmann V, Gaengler P. Correlation between clinical scoring of secondary caries at crown margins and histologically assessed extent of the lesions. Int J Prosthodont 2000;13:453-9.
16. Zoellner A, Weber HP, Gaengler P. Secondary caries in crowned teeth: Correlation of clinical and radiographic Findings. J Prosthet Dent 2002; 88:314-9.
17. Mileman PA, van der Weele LT. Accuracy in radiographic diagnosis: Dutch practitioners and dental caries. J Dent 1990;18:130-6.
18. Peers A, Hill FJ, Mitropoulos CM, Holloway PJ. Validity and reproducibility of clinical examination, fibre-optic transillumination, and bite- wing radiology for the diagnosis of small approximal carious lesions: an in vitro study. Caries Res 1993;27:307-11.
19. Pitts NB, Rimmer PA. An in vivo compari- son of radiographic and directly assessed clinical caries status of posterior approximal surfaces in pri- mary and permanent teeth. Caries Res 1992;26:146- 52.
20. Rugg-Gunn AJ. Approximal carious lesions. A comparison of the radiological and clinical appearances. Br Dent J 1972;133:481-4.
21. Hopcraft MS, Morgan MV. Comparison of radiographic and clinical diagnosis of approximal and occlusal dental caries in a young adult popula- tion. Community Dent Oral Epidemiol 2005; 33: 212-8.
22. Aydın Ü, Ermiş RB, Baykul T. İki yönlü amalgam restorasyonların değerlendirilmesinde gözlemci içi ve gözlemciler arası uyum. EÜ Dişhek Fak Derg 2003;24:29-33.
23. Akkaya N, Kansu O, Kansu H, Cagirankaya LB, Arslan U. Comparing the accuracy of panora- mic and intraoral radiography in the diagnosis of proximal caries. Dentomaxillofac Radiol. 2006; 35: 170-4.
24. Zafersoy Z, Kayaoğlu G, Erten Can H. Farklı iki görüntüleme yöntemi ile elde edilen bite- wing radyografilerin DMFS indeks sistemine olan etkilerinin değerlendirilmesi.GÜ Dişhek Fak Derg 2002;19:15-8.
25. Akarslan ZZ, Uzun O, Tazegül S, Topuz O, Erten H, Gürbüz F. Arayüz çürüklerinin teşhisinde utraspeed, ektaspeed, ektaspeed plus, insight filmler, radyovizyografi, operasyon mikroskobu ve gözle muayenenin etkinliklerinin karşılaştırılması. GÜ Dişhek Fak Derg 2006;23:5-9.
26. Zafersoy Z, Kayaoğlu G, Topuz Ö, Can EH. Proksimal çürüklerin teşhisinde konvansiyonel radyografik teknikler rvg ve klinik muayenenin karşılaştırılması. GÜ Dişhek Fak Derg 2001;18:9-12.
27. Purton DG, Ng BP, Chandler NP, Monteith BD. The bitewing radiograph as an assessment tool in fixed prosthodontics. J Oral rehabil 2004;31:562- 7.
28. Matalon S, Feuerstein O, Kaffe I. Diagnosis of approximal caries: bite-wing radiology versus the ultrasound caries detector. An in vitro study. Oral Surg Oral Pathol Oral Med Oral Radiol Endod 2003; 95:626–31.
29. Farman AG. There are good reasons for selecting panoramic radiography to replace the intra- oral full-mouth series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 653–654.
30. Scarfe WC, Nummikoski P, McDavid WD, Welander U, Tronje G. Radiographic interproximal angulations: Implication for rotational panoramic radiography. Oral Surg Oral Med Oral Pathol 1993; 76:664–72.
31. Baydaş S, Duymuş yeşil Z,Yanıkoğlu N, Ceylan G, Mutluergil F, Doğan M, Denizoğlu S, Bayındır F. Kuron ve köprülerin sökülme neden- lerinin incelenmesi. Atatürk Üniv Diş Hek Fak Derg 1998; 8:37-43.
32. Foster LV. The relationship between failure and design in conventional bridge work from gene- ral practice. J Oral Rehabil 1991;18:491-5.
33. Valderhaug J. A 15 year clinical evaluation of fixed prosthodontics. Acta Odontol scand 1991; 49:35-40.
34. Kantor ML, Zeichner SJ, Valachovic RW, Reiskin AB. Efficacy of dental radiographic prac- tices: options for image receptors, examination selec- tion, and patient selection. JADA 1989; 119:259- 64.
35. Danforth RA, Clark DE. Effective dose from radiation absorbed during panoramic examina- tion with a new generation machine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:236-43.