Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars
Roula Berbari, Alexandre Khairallah, Hussein F Kazan, Mohamad Ezzedine, Daniel Bandon
Affected dentin, Deep carious lesions, Digital radiography, Remaining dentin
Citation Information :
Berbari R, Khairallah A, Kazan HF, Ezzedine M, Bandon D. Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars. Int J Clin Pediatr Dent 2018; 11 (1):23-28.
Aim: This study was carried out to assess the reliability of measurements of the remaining dentin thickness under deep carious lesions as estimated from digital radiographs. The goal is to allow clinicians to correlate the radiographic measurement to the exact value of the remaining dentin thickness. The results obtained will be tested further in a study that will evaluate the histopathologic pulpal state according to the caries’ lesion depth.
Materials and methods: The study was conducted in the Pediatric Dentistry Department at the Lebanese University, in collaboration with the research platform of the same university. Fifty deciduous molars with deep caries on proximal surfaces liable to extraction were collected. Before extraction, a digital in vivo periapical radiograph was taken, followed by manual excavation of the caries. After excavation, another radiograph was taken before the tooth was sectioned through the deepest site of the lesion. Another radiograph was then obtained for each tooth fragment. To evaluate the exact thickness of the remaining dentin, each fragment was measured on a histologic macrophotograph. The measurements were then compared statistically using a paired-samples t-test, and a correlation was sought.
Results: No significant difference was observed in the radiographs between the measurement of the remaining dentin thickness before and after the excavation of caries. In contrast, the radiographic measurements of remaining dentin thickness were underestimated by an average of 20% compared with those made with macrophotographs.
Limitations: Interpretation of radiographs varies from one practitioner to another and is a function of the operator's visual acuity.
Conclusion: Measuring the residual dentin thickness on a radiograph underestimates the actual thickness by about 20%. Further studies are needed to confirm these results.
Clinical significance: Our results indicate that remaining dentin thickness is greater in reality than is shown on a radiograph. This information can help clinicians to refine their diagnoses and treatment plans.
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