In vivo study of the effectiveness of quantitative percussion diagnostics as an indicator of the level of structural pathology of teeth after restoration.
BACKGROUND
Conventional diagnostic aids based upon imagery and patient symptoms do not indicate whether restorative treatments have eliminated structural pathology.


OBJECTIVE
The purpose of this clinical study was to evaluate quantitative percussion diagnostics (QPD), a mechanics-based methodology that tests the structural integrity of teeth noninvasively. The study hypothesis was that QPD would provide knowledge of the structural instability of teeth after restorative work.


METHODS
Eight participants with 60 sites needing restoration were enrolled in an IRB-approved clinical study. Each participant was examined comprehensively, including QPD testing. Each site was disassembled and microscopically video documented, and the results were recorded on a defect assessment sheet. A predictive model was developed for the pathology rating based on normalized fit error (NFE) values using data from the before treatment phase of the study published previously. Each restored site was then tested using QPD. The mean change in NFE values after restoration was evaluated by the pathology rating before treatment. The model was then used to predictively classify the rating after restoration based on the NFE values after treatment. The diagnostic potential of the rating was explored as a marker for risk of pathology after restoration.


RESULTS
After restoration, 51 of the 60 sites fell below an NFE of 0.04, representing a greatly stabilized tooth site sample group. Several sites remained in the high-risk category and some increased in pathologic micromovement. Two models were used to determine severity with indicative cutoff points to group sites with similar values.


CONCLUSIONS
The data support the hypothesis that QPD can indicate a revised level of structural instability of teeth after restoration.
Co-Executive Director, Research and Teaching Divisions, Newport Coast Oral Facial Institute, Newport Beach, Calif. Electronic address: cgsheets@ncofi.org.
Cherilyn G
CG
Sheets
Co-Executive Director, Research and Teaching Divisions, Newport Coast Oral Facial Institute, Newport Beach, Calif.
Jean C
JC
Wu
Research Assistant, Research Division, Newport Coast Oral Facial Institute, Newport Beach, Calif.
Samer
S
Rashad
Assistant Director, Department of Statistics, University of California, Irvine, Calif.
Michael
M
Phelan
Professor, Chemical Engineering & Material Science and Biomedical Engineering, The Henry Samueli School of Engineering at University of California, Irvine, Calif.
James C
JC
Earthman
D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods; D003799:Dental Stress Analysis; D006801:Humans; D010474:Percussion / Q000379:methods*; D019553:Tooth, Nonvital / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery