Comparison of direct digital and conventional imaging with Ekta Speed Plus and INSIGHT films for the detection of approximal caries

Purpose: To evaluate the accuracy of approximal caries detection comparing enhanced and unenhanced Sidexis CCD-based digital image with Ektaspeed Plus and INSIGHT films. Methods: Fifty-two extracted premolars were imaged under identical standardized geometric and exposure conditions. Four observers, using five points confidence scale, rated 104 approximal surfaces for the presence or absence of carious lesions by means of four image modalities: (1) observer enhanced; (2) unenhanced Sidexis displays; (3) E speed films and (4) F speed film. Histologic sections served as validating criterion for the presence and depth of carious lesions. Diagnostic accuracy was measured as the area beneath the ROC curve. Results: Mean ROC (receiver operating characteristic) curve areas for approximal surfaces were 0.865 (E speed), 0.856 (F speed), 0.816 (unenhanced Sidexis) and 0.776 (observer enhanced). There were no significant differences between unenhanced digital Sidexis and films. Observer enhanced Sidexis images exhibited a statistically significant lower diagnostic accuracy than the film images for two of the observers.

Enamel caries resistance accidentally irradiated by the Nd : YAG laser

When the carious tissue is eliminated either by conventional methods (with burs) or with lasers, the risk of accidentally damage the surface of adjacent teeth may occur, which hypothetically could lead to a more susceptible surface for canes formation. This in vitro study aims to evaluate the caries resistance of the dental enamel surface irradiated by the Nd:YAG laser applied in conditions simulating accidental exposition. Thirteen third molars were used in this study. The experimental groups were: G1: sound control and control + carious; G2: contact Nd:YAG laser at 0.75, 1, 2, or 3 W; 10 Hz; 3 sec (27, 35, 71, and 106 J/cm(2)); G3: same parameters from G2 + caries artificial induction through the demineralization and demineralization (DES/RE) dynamic model. The caries resistance analysis was evaluated by the superficial morphological aspect through SEM images and also by Ca/P proportion through energy dispersive X-ray spectroscopy (EDX). The micrograph images showed that the Nd:YAG laser changed the normalmorphology of the enamel prisms resulting in a melted and re-solidified surface intensified with the power increase. Significant statistical differences were observed applying the Kruskal-Wallis statistical test (p <= 0.01) among the Nd:YAG laser irradiated groups and the control with caries regarding the Ca/P proportion. As an exception, this was not observed when 3 W; 10 Hz; 3 sec; 106 J/cm(2) was applied and posteriously submitted to a cariogenic challenge. The results indicate that the Nd:YAG laser accidental irradiation at low power settings did not represent risks to the enamel caries resistance.