BACKGROUND:Radiographs, adjunct to clinical examination are always valuable complementary methods for dental caries detection. Recently, progressing in digital imaging system provides possibility of software designing for automatically dental caries detection.OBJECTIVES:The aim of this study was to develop and assess the function of diagnostic computer software designed for evaluation of approximal caries in posterior teeth. This software should be able to indicate the depth and location of caries on digital radiographic images.MATERIALS AND METHODS:Digital radiographs were obtained of 93 teeth including 183 proximal surfaces. These images were used as a database for designing the software and training the software designer. In the design phase, considering the summed density of pixels in rows and columns of the images, the teeth were separated from each other and the unnecessary regions; for example, the root area in the alveolar bone was eliminated. Therefore, based on summed intensities, each image was segmented such that each segment contained only one tooth. Subsequently, based on the fuzzy logic, a well-known data-clustering algorithm named fuzzy c-means (FCM) was applied to the images to cluster or segment each tooth. This algorithm is referred to as a soft clustering method, which assigns data elements to one or more clusters with a specific membership function. Using the extracted clusters, the tooth border was determined and assessed for cavity. The results of histological analysis were used as the gold standard for comparison with the results obtained from the software. Depth of caries was measured, and finally Intraclass Correlation Coefficient (ICC) and Bland-Altman plot were used to show the agreement between the methods.RESULTS:The software diagnosed 60% of enamel caries. The ICC (for detection of enamel caries) between the computer software and histological analysis results was determined as 0.609 (95% confidence interval [CI] = 0.159-0.849) (P = 0.006). Also, the computer program diagnosed 97% of dentin caries and the ICC between the software and histological analysis results for dentin caries was determined as 0.937 (95% CI=0.906-0.958) (P < 0.001). Bland-Altman plot showed an acceptable agreement for measuring the depth of caries in enamel and dentin.CONCLUSIONS:The designed software was able to detect a significant number of dentin caries and acceptable measuring of the depth of carious lesions in enamel and dentin. However, the software had limited ability in detecting enamel lesions.
Introduction One of the key factors in successful endodontic therapy is to adequately fill the root canals. The aim of this in vitro study was to compare the quality of four different root canal obturation techniques: cold lateral condensation (CLC), warm vertical condensation (WVC), Obtura II (OII) and Gutta Flow (GF) by using micro-computed tomography (micro CT). Materials and Methods A total of 20 extracted maxillary first molars prepared with ProTaper files, were randomly divided into four groups. Micro CT was used to measure the internal volume of root canals. Following application of AH26 sealer to canal obturation, new micro-CT images were taken and the volume percentage (VP) of voids, gutta-percha and sealer at different levels were calculated with CT software. Data was statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results The highest percentage of filling material was observed in GF group followed by OII with no statistically significant difference (P>0.05). These two groups had a significantly more acceptable filling than WVC and CLC groups (P<0.05). Voids were detected in all samples. There was a significant difference between the highest and the lowest percentage of voids in CLC (19.6%) and GF groups (6.7%), respectively. In the apical third, CLC and OII showed the highest and the lowest percentage of voids (5.5% and 2.6%) and the lowest and highest percentage of gutta-percha (76.52% and 94.26%), respectively. These differences were statistically significant (P<0.05). Conclusion None of the root canal filled teeth were gap-free. GF and CLC techniques showed the highest and lowest VP of obturation materials, respectively.