Cone Beam Computed Tomography- An Effective Tool in Detecting Caries Under Fixed Dental Prostheses

J Clin Diagn Res. 2016 Aug;10(8):ZC10-3. doi: 10.7860/JCDR/2016/18589.8228. Epub 2016 Aug 1.

Abstract

Introduction: Caries under restorations is the most common reason for re-treatment and replacement in restorative failures. To avoid failures of fixed dental prostheses, it is important to diagnose caries under it earlier. Without image degradation and metal artifacts, Cone Beam Computed Tomography (CBCT) can be the solution to detect caries without removing fixed dental prostheses.

Aim: The aim of this study was to determine the efficacy of CBCT in detecting caries under fixed dental prostheses.

Materials and methods: Each specimen was scanned with CBCT for evaluation of secondary caries under fixed prostheses. Exposure parameters were 60 kVp and 3mA. Field of View (FOV) used was 8cm X 8cm. According to International Caries Detection and Assessment System (ICDAS) criteria, six Grade 6 carious extracted teeth were selected. All teeth were prepared with four different specimens - full metal, metal-ceramic, full ceramic and metal-acrylic crowns for each tooth. Each specimen was scanned by CBCT. T-test was performed for mean gray value differences between caries and noncaries regions of each material. Gray values were recorded and evaluated for different parameters using two-way analysis of variance.

Results: Significant differences were found with respect to material (full metal, metal-ceramic, full ceramic and metal-acrylic) and situation (caries/noncaries) (p<0.001). There were no significant differences with respect to location (anterior or posterior). Mean gray values of caries and noncaries regions were found to be different for each material.

Conclusion: CBCT can be used as a post-treatment diagnostic technique for detecting caries under fixed prostheses without removing it.

Keywords: Dentin; Diagnosis; Mean gray value.