The influence of amalgam fillings on the detection of approximal caries by Cone Beam Computed Tomography - in vitro study.

Dento maxillo facial radiology

PubMedID: 24986630

Kulczyk TJ, Dyszkiewicz Konwinska M, Owecka M, Krzyzostaniak J, Surdacka A. The influence of amalgam fillings on the detection of approximal caries by Cone Beam Computed Tomography - in vitro study. Dentomaxillofac Radiol. 2014;20130342.
OBJECTIVE
The aim of this CBCT investigation into the detection of caries was to assess the influence of artefacts produced by the presence of amalgam fillings located in the vicinity.

MATERIAL AND METHOD
102 non-cavitated premolar and molar teeth were placed in blocks of silicone with approximal contacts consisting of three sound or carious teeth and one MOD amalgam-filled tooth in between. Radiographs of all the teeth were recorded using the CBCT system (NewTom 3G FOV9'). Data from the CBCT unit were reconstructed and sectioned in the mesiodistal tooth plane. Images were evaluated twice by two observers, using a five-step confidence scale. After the CBCT examination the teeth were individually sectioned in the mesiodistal direction with a diamond saw . Using a light microscope at 40 times magnification the true morphological status of all approximal surfaces was established.

RESULTS
Sensitivity of the Cone Beam Computed Tomography for the detection of caries on surfaces located proximally and distally to an amalgam filing ranged from 0.27 to 0.3 for enamel, and from 0.47 to 0.56 for dentin. Specificity values for enamel proximal and distal lesions were of 0.48 and 0.53 respectively for enamel and 0.33 to 0.38 respectively for proximal and distal dentin cases. Intra-observer reliability was 0.84 and inter-observer reliability was 0.49 CONCLUSION: Due to its low specificity scans from a CBCT examination should not be used to determine the presence of demineralization of the tooth surface when amalgam fillings are present in the region of interest.