Influence of Radiopacity of Dental Composites on the Diagnosis of Secondary Caries: The Correlation Between Objective and Subjective Analyses

Author:

Cruz AD1,Esteves RG2,Poiate IAVP3,Portero PP4,Almeida SM5

Affiliation:

1. Adriana Dibo Cruz, DDS, PhD, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Radiology, Nova Friburgo, Rio de Janeiro, Brazil

2. Renata Gama Esteves, DDS student, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Nova Friburgo, Brazil

3. Isis Andréa Venturini Pola Poiate, DDS, PhD, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Clinic, Nova Friburgo, Rio de Janeiro, Brazil.

4. Priscila Paiva Portero, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Clinic, Nova Friburgo, Rio de Janeiro, Brazil.

5. Solange Maria Almeida, DDS, MS, PhD, Dentistry School of Piracicaba, State University of Campinas, Department of Oral Diagnostic, Piracicaba, Brazil

Abstract

SUMMARY This study aimed to objectively evaluate the radiopacity of different dental composites and their subjective influence on diagnosing secondary caries–like lesions and how these results correlate. For objective analysis, three resin specimens (1 mm thick, with a 4-mm internal diameter) were made with four composites: 1) Charisma; 2) Filtek Z250; 3) Prisma AP.H; and 4) Glacier. Three human teeth were selected and then mesio-distally sectioned (1 mm thick) to make the dental specimens. An aluminum (Al) wedge (12 steps, 1 mm thick, 99.8% purity) was used as an internal standard to calculate the radiopacity. For subjective analysis, 20 human teeth were selected and then prepared with a mesio-occluso-distal (MOD) inlay cavity, with half the teeth receiving a round cavity to simulate the carious lesion. The MOD was restored using the composites at four different times. Standardized radiographs were acquired and then digitized (300 dpi and eight-bit TIFF) for both analyses. A histogram objectively measured the pixel intensity values of the images, which were converted into millimeters of Al using linear regressions. Eight observers subjectively evaluated the images using a five-point rating scale to diagnose the caries. The data were statistically analyzed using the Student t-test, the Kappa test, diagnostic testing, and the Pearson correlation coefficient (α=0.05). All materials showed radiopacity values compatible with dental tissues (p>0.05); Glacier was similar to dentin and Prisma AP.H was similar to enamel, while the remaining materials showed a middle radiopacity. Prisma AP.H and Glacier differed (p<0.05) in relation to their accuracy to caries diagnosis, with Glacier having greater accuracy. There was a correlation between objective and subjective analyses with negative linear dependence. An increase in the material's radiopacity could have a subjectively negative influence on the diagnosis of secondary caries; thus, an ideal radiopacity for a dental composite is closer to the dentin image and produces similar attenuation to X-rays than does dentin.

Publisher

Operative Dentistry

Subject

General Dentistry

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