ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Cone Beam Computed Tomography Units Can Be Useful In Detecting Buccal Recurrent Caries
Clinical Question In patients with recurrent caries, can a CBCT unit detect decay better than traditional bite wings?
Clinical Bottom Line For patients with buccal recurrent caries, CBCT can be a useful diagnostic tool. This is supported by a lab study in which two dentomaxillofacial radiologists and a prosthodontist consistently achieved a higher Cohen’s kappa coefficient during diagnosis.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22917443Murat/2012120 extracted molars and premolars, restored either with thermoplastic polymer or Ni-Cr crownsEx Vivo Study
Key resultsKappa coefficients ranged from 0.517 - 0.691 for intraoral film and 0.582 - 0.649 for CBCT. The following values include all three observers: sensitivity ranged from 0.206-0.912, specificity ranged from 0.209-0.953, PPV ranged from 0.458-0.807, NPV ranged from 0.388-0.886, and FPR ranged from 0.07-0.791. ROC analysis and sensitivity measurement indicated better performance for both CBCT systems than for intraoral detectors.
Evidence Search (("Cone-Beam Computed Tomography"[Mesh]) AND ("Dental Caries"[Mesh] OR (caries AND recurrent))) OR (("cone-beam computed tomography" OR CBCT) AND ("dental caries" OR "recurrent caries"))
Comments on
The Evidence
Gold standard was investigator’s knowledge of tooth status; lesions had been produced by a bur. Images were interpreted by three calibrated and experienced observers. Specificity, sensitivity, and receiver operating curve (ROC) analyses were used to compare the imaging methods. Teeth with artificial buccal caries were placed in alveolar sockets of dry human mandible. Radiographic technology used included intraoral film, intraoral digital, Veraviewepocs 3D, and Kodak 9000. Limitations to the study include but are not limited to: 1- The use of only two CBCT units, where many different technologies are available on the market; 2 - Lesions were artificially produced using a bur. Only buccal lesions were used; 3 – amount of observers participating in study
Applicability According to Murat, CBCT assisted in diagnosing recurrent buccal caries amongst the observers. Though there is more literature available for CBCT used to diagnose initial carious lesions, there is a lack of information available in the use of CBCT for detection of recurrent caries.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Restorative Dentistry)
Keywords Recurrent caries, cone beam computed tomography, dentomaxillofacial radiology
ID# 2426
Date of submission: 03/18/2013spacer
E-mail garrettp@livemail.uthscsa.edu
Author Phillip Garrett
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail deahl@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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