Posttreatment diagnosis of caries under fixed restorations: A pilot study

Abstract

Conventional radiographic techniques are insufficient for detecting caries under fixed restorations or for acquiring clear images of the disease. Advanced radiographic techniques such as cone beam computerized tomography may be a solution. The purpose of this study was to assess the viability of detecting and characterizing caries under complete-ceramic and metal-supported crowns by using cone beam computerized tomography. A grade 6 carious molar tooth according to the International Caries Detection and Assessment System criteria was selected. The tooth was prepared, and 3 different crowns were fabricated in a dental laboratory: yttria tetragonal zirconia polycrystal (Y-TZP) ceramic, lithium disilicate ceramic, and metal ceramic. The crowns were placed on the prepared tooth, and each specimen was subjected to cone beam computerized tomography. Opacity values were recorded and evaluated with 2-way ANOVA. Multivariate comparisons (Tukey was performed to assess the mean gray value differences of the materials between caries and dentin, and the Mann-Whitney U test was performed to assess the mean gray value differences between caries and dentin for each material (α=.05). Carious borders and cavities were detected under the 3 ceramic crown specimens with a cone beam computerized tomography radiographic technique. The statistical analysis of the radiopacity mean gray value was at the borderline of significance for the specimen radiographies. Significant differences were found with respect to materials, location, and the interaction between these 2 factors (P<.001). Cone beam computerized tomography can be used as a posttreatment diagnostic technique for detecting caries under high atomic numbered crowns and partial fixed dental prostheses.