• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.432-438
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• 2017

PURPOSE. The purpose of this study was to evaluate the in vitro validity of quantitative light-induced fluorescence-digital (QLF-D) and laser fluorescence (DIAGNOdent) for assessing proximal caries in extracted premolars, using digital radiography as reference method. MATERIALS AND METHODS. A total of 102 extracted premolars with similar lengths and shapes were used. A single operator conducted all the examinations using three different detection methods (bitewing radiography, QLF-D, and DIAGNOdent). The bitewing x-ray scale, QLF-D fluorescence loss (${\Delta}F$), and DIAGNOdent peak readings were compared and statistically analyzed. RESULTS. Each method showed an excellent reliability. The correlation coefficient between bitewing radiography and QLF-D, DIAGNOdent were -0.644 and 0.448, respectively, while the value between QLF-D and DIAGNOdent was -0.382. The kappa statistics for bitewing radiography and QLF-D had a higher diagnosis consensus than those for bitewing radiography and DIAGNOdent. The QLF-D was moderately to highly accurate (AUC = 0.753 - 0.908), while DIAGNOdent was moderately to less accurate (AUC = 0.622 - 0.784). All detection methods showed statistically significant correlation and high correlation between the bitewing radiography and QLF-D. CONCLUSION. QLF-D was found to be a valid and reliable alternative diagnostic method to digital bitewing radiography for in vitro detection of proximal caries.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.271-278
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• 1987

The purpose of the present study was to investigate associations between periapical and bitewing techniques by assessing the crestal alveolar bone. This article also reports the ability of these two techniques to correctly detect evidence of interproximal dental caries, and comparison between the interproximal overlapping of teeth. Bitewing and periapical radiographs were used from posterior quardants of 243 dental students in Seoul National University. The distance from cemento-enamel junction to the alveolar crest (CEJ-AC) was measured for each proximal surface from the distal of cuspid to the distal of second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows: 1. In maxilla, a significant t ratio with a P value of 0.05 or less reached for 100% and in mandible, reached for 94%. 2. The anatomic limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 3. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used. 4. The number of the interproximal overlapping was the largest medial side of the maxillary second molar, while the smallest at the distal side of the mandibular second premolar. And the overall number of the interproximal overlapping was more (538) in the periapical technique than in the bitewing technique (372). 5. The interproximal dental carious lesions were detected more (74) on the bitewing films than on the periapical ones (23). The fact was resulted from the small number of interproximal overlapping and relative easi- ness of obtaining horizontal angulation in taking the bitewing radiographs.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.75-83
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• 1985

Bitewing and periapical radiographic techniques are used in clinical and epidemiological studies to assess crestal alveolar bone levels. The purpose of the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. Bitewing and periapical radiographs were available from posterior quadrants of 120 subjects. The distance from cemento-enamel junction to the alveolar crest (CEJ -CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows; 1. In maxilla, a significant t ratio with a P value of 0.05 or less was reached for 78% and in mandible reached for 39%. 2. Pearson correlations were calculated 32 surfaces (89%) had values below 0.70 and so, data obtained by these techniques can not be used interchangeably on an individual or group basis. 3. In situations where the periapical measure was greater than the bitewing, it ranged up to 20.7% greater with a mean 9.8%. Where the bitewing was greater than periapical, it ranged up to 51. 9% greater, with a mean 18.2%. 4. The percentage difference was greater in maxillary posterior areas than in mandibular molar, premolar areas. A lower prevalence of significant differences was attributed to relatively more simple root and favorable radiographic conditions in mandibular molar and premolar areas. 5. The anatomical limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 6. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.323-330
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• 2004

The purpose of this study was to evaluate the diagnostic validity of early proximal caries lesions using laser fluorescence and whether the detection could be enhanced using a fluorescent dye. Direct visual examination and bitewing radiograph were used for comparison. The subjects of this study were 30 children of $3{\sim}9$ years old. Laser fluorescence and dye-enhanced laser fluorescence(mixed wavelength of 488 and 514 nm) were used and viewed through glasses(excluding wavelength<520 nm). For dye-enhanced laser fluorescence a 0.075% sodium fluorescein dye was applied before examination. Proximal caries lesion of each subject was assessed using visual examination, bitewing radiograph, laser fluorescence, and dye-enhanced laser fluorescence. The results in the three detection methods were compared to the assessment of bitewing radiograph. The results from the present study can be summarized as follows: 1. There was highly correlation(r=0.725-0.911) between the bitewing radiograph and all three detection methods(p<0.05) 2. The reproducibility(kappa value) of the visual examination, laser fluorescence and dye-enhanced laser fluorescence comparing with bitewing radiograph of proximal caries was 0.451, 0.683, 0.772, respectively. There was highest correlation between dye-enhanced laser fluorescence and bitewing radiograph for detection of proximal caries. The results from this study indicated that the dye-enhanced laser fluorescence considered to be accurate and reliable method in detecting proximal caries.

• Imaging Science in Dentistry
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• v.41 no.4
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• pp.143-150
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• 2011

Purpose : The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. Materials and Methods : One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve ($A_z$) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). Results : The mean $A_z$ values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest $A_z$ value. Conclusion : Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.222-226
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• 2014

Purpose: This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. Methods: Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. Results: This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. Conclusions: Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.

• Imaging Science in Dentistry
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• v.48 no.2
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• pp.87-96
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• 2018

Purpose: The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods: Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results: For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations(P>.05), but showed no discriminatory ability for amalgam restorations(P<.05). Conclusion: Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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• pp.265-275
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• 1993

The purpose of this study was to compare the interpretation results of the panoramic radiographs with those of intraoral radiographs in evaluation of alveolar bone loss. All radiographs were obtained from 100 patients who had visited the Dental Infirmary of Kyungpook National University Hospital for periodontal state evaluation. The results were as follows: The percentages of interpretable sites were 95.9%(94.6% in maxilla, 97.4% in mandible) on the intraoral radiographs, and 90.7%(84.0% in maxilla, 97.3% in mandible) on the panoramic radiographs. The concordance of interpretation scores of marginal bone loss between intraoral and panoramic radiographs was 66.3%(65.6% in maxilla, 66.8% in mandible). And according to the site, the highest concordance was in the distal surface of the mandibular 2nd premolar at 82.0%, and the distal surface of the mandibular 1st premolar(76.8%), the distal surface of the maxillary central incisor(75.8%), the mesial surface of the 2nd premolar (75.0%) in descending order of frequency. According to the interpretation scores of the marginal bone loss, the percentages of concordance between intraoral and panoramic radiographs were the highest on the score 10 at 76.4%, and the lowest on the score 8, 9. And the percentages of concordance were inverse proportional rate from the score 5 to the score 9. Number of the observed sites of the furcation involvement in bitewing and panoramic radiographs were 268 sites, and the percentage of interpretable sites was 92.9% in bitewing radiographs and 86.6% in panoramic radiographs. And the concordance rate of interpretation was 79.5%.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.1013-1023
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• 2018

Objectives: The purpose of this study is to evaluate dental hygiene students' recognition of safety management and phantom practice in dental radiology. Methods: The study subjects were 409 students in six regions who completed a dental radiology practice course and had on-job experience more than once. After understanding the study purpose and contents, they answered a questionnaire. The main jobs in dental radiology were analyzed. Results: As a result, regarding the most difficult aspects of dental radiology practice, "it is impossible to irradiate the mouth directly with X-rays" was the most common response (29.1%). Regarding the question "what is the main role of students in dental radiology practice?", the answer "it is shooting simulations using phantoms" accounted for 59.7% of responses. The most difficult regions in bisecting and paralleling radiography with a phantom were found to be the maxillary & mandibular molars and premolars. The most difficult technique was reported to be locating XCP maintenance to fit inside the mouth for both molars and premolars. The most difficult region to perform bitewing radiography using the phantom was the molar region (2.87), and the most difficult to perform occlusal radiography approaches were maxillary anterior general occlusal radiography (2.92) and mandibular cross-sectional occlusal radiography (3.00). Conclusions: The most technically difficult point in bitewing and occlusal radiography was the correct positioning of the vertical and horizontal angles. Radiography practice was considered to be more effective than previous mutual practice in terms of analysis of anatomical structures and patient treatment methods. Therefore, it will be necessary to improve policy regarding dental radiography practice at the department of dental hygienics and revise the necessary laws and regulations.