The Influence of Different Dental Restorations on Detection of Proximal Caries by Cone Beam Computed Tomography: An Ex-Vivo Study

Abstract

This study aimed to evaluate the effects of different dental restorations on the diagnostic performance of i-CAT® CBCT in detection of proximal caries. Forty-six sound human premolar and molar teeth and one dry human mandible were used. Chemical artificial caries was induced in proximal surfaces of 40 teeth by exposing them to 5% formic acid for different durations to induce different lesion depths. The teeth were then divided into 20 groups each composed of one premolar and one molar. Six molars were used as artifacts producing molars; five of them were restored with amalgam, composite, reinforced GIC MOD fillings, zirconia, and e-max CAD full crowns, while one molar remained without a restoration. Each one of the artifact producing molars was adapted to the empty socket of the mandibular right first molar in contact with one group of artificially carious teeth adapted to the empty sockets of the second premolar and the second molar. Then the whole mandible was covered with pink wax and scanned by i-CAT® CBCT unit (Imaging Sciences International, Hatfield, PA). The 20 groups of demineralized teeth were scanned with each artifact producing molar. All CBCT images were evaluated separately by two calibrated oral radiologists twice using a four-grade scale. Histological validation served as the gold standard. Each tooth was sectioned mesiodistally and examined under a stereo-microscope (Olympus DP 10, SZ-PT, Japan) by two oral histologists together using a four-grade scale. Data was tabulated compared and statistically analyzed.