Detection of artificial demineralization bordering different types of laminate veneers using visual inspection and storage phosphor radiography.
OBJECTIVE
The objective of this study is to compare the diagnostic accuracy of visual inspection (VI) and storage phosphor plate (SPP) radiography for the detection of artificial demineralization bordering different laminate veneers.


METHODS
Twenty human maxillary canine teeth were prepared. All-ceramic (A) and hybrid ceramic (H) laminate veneers were fabricated and luted. Veneered teeth were covered except for a circular window on the proximal surface bordering restorations. Teeth were kept in acetic acid buffer to create demineralization and imaged with a SPP system. Ten observers evaluated all teeth first visually then with SPP images for the presence/absence of demineralization. Teeth were examined using scanning electron microscopy (SEM) as well. The accuracy was expressed as the area under the ROC curves (A(z)). Pair-wise comparisons were performed using two-way ANOVA and post hoc t test (p = 0.05). Fleiss kappa (κ) was used for agreement.


RESULTS
SPP radiography was better than the VI for both veneers (p = 0.004). The A(z)s of two veneers were different for both VI (p < 0.005) and SPP (p < 0.005). SEM evaluation revealed lesions confined to enamel. κ was fair for H, and fair to moderate for A. Agreement was higher for the radiographic evaluation for both veneers.


CONCLUSIONS
Enamel demineralizations bordering hybrid and ceramic laminate veneers can be detected better with SPP radiography than VI and detectability was better for all-ceramic veneers than the hybrid ceramic ones.


CONCLUSIONS
Early detection of enamel demineralizations bordering laminate veneers would result in time-saving and less-invasive treatment methods; therefore, SPP radiography may be recommended in clinically suspicious cases since it provides better diagnostic accuracy.
School of Dentistry, Department of Prosthodontics, Ege University, Izmir, Turkey.
Erhan
E
Cömlekoğlu
Erinç
E
Önem
Mine
M
Dündar Çömlekoğlu
B Güniz
BG
Baksı
Ali
A
Mert
D019342:Acetic Acid / Q000009:adverse effects; D000134:Acid Etching, Dental / Q000379:methods; D000328:Adult; D000537:Aluminum Oxide / Q000737:chemistry; D019540:Area Under Curve; D002484:Cementation / Q000379:methods; D003188:Composite Resins / Q000737:chemistry; D003481:Cuspid / Q000000981:diagnostic imaging / Q000473:pathology; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D045662:Dental Etching / Q000379:methods; D003776:Dental Porcelain / Q000737:chemistry; D017267:Dental Prosthesis Design; D003801:Dental Veneers; D017220:Dentin-Bonding Agents / Q000737:chemistry; D006801:Humans; D006858:Hydrofluoric Acid / Q000737:chemistry; D008689:Methacrylates / Q000737:chemistry; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D015588:Observer Variation; D010808:Physical Examination / Q000706:statistics & numerical data; D011140:Polyurethanes / Q000737:chemistry; D012372:ROC Curve; D011859:Radiography; D019279:Resin Cements / Q000737:chemistry; D013499:Surface Properties; D017001:Tooth Demineralization / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014963:X-Ray Intensifying Screens / Q000706:statistics & numerical data
D003188:Composite Resins; D017220:Dentin-Bonding Agents; D008689:Methacrylates; D011140:Polyurethanes; D019279:Resin Cements; C078484:Syntac dentine adhesive; C493120:lithia disilicate; C091839:urethanetrimethacrylate; D003776:Dental Porcelain; C103502:Variolink; D000537:Aluminum Oxide; D019342:Acetic Acid; D006858:Hydrofluoric Acid