Abstract

AimThis 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 methodsThe 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 macropho-tograph. The measurements were then compared statistically using a paired-samples t-test, and a correlation was sought.ResultsNo 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.LimitationsInterpretation of radiographs varies from one practitioner to another and is a function of the operator’s visual acuity.ConclusionMeasuring the residual dentin thickness on a radiograph underestimates the actual thickness by about 20%. Further studies are needed to confirm these results.Clinical significanceOur 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.How to cite this article: Berbari R, Khairallah A, Kazan HF, Ezzedine M, Bandon D, Sfeir E. Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars. Int J Clin Pediatr Dent 2018;11(1):23-28.

Highlights

  • Pulp vitality tests are often unreliable in pediatric dentistry.[1]

  • No significant difference was observed in the radiographs between the measurement of the remaining dentin thickness before and after the excavation of caries

  • The radiographic measurements of remaining dentin thickness were underestimated by an average of 20% compared with those made with macrophotographs

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Summary

Introduction

Estimation of the remaining dentin thickness (RDT) between the carious cavity and the pulp on a radiograph is crucial, and there is growing consensus that the RDT may be the most predictive measure of pulpal reactions.[4] difficulties have been noted in the interpretation of radiographs, which show the location of the decay but do not specify its exact extent.[5,6] radiographs are ambiguous when it comes to precise measurement of the RDT in deep cavities.[7]. The depth of the carious cavity is frequently mentioned in the literature, mainly because the RDT is an important factor to ensure long-term clinical success in pulpal parenchyma protection. After the restoration of 49 deep cavities, Murray et al[11] concluded that a thickness

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