Dental Caries, Periodontal Diseases
Conditions
Keywords
Radiography, Bitewing
Brief summary
The aims of this research are to determine if vertical bitewings will be more effective and more comprehensive for the diagnosis of caries and the level of alveolar bone loss than the horizontal bitewing technique for the patients at King Abdulaziz University over the age of 18. This is a cross sectional study. All the images in this study will be conducted at School of Dentistry, King Abdulaziz University. Each patients will be exposed to 4 horizontal bitewing for posterior teeth ( standard of care ) and 4 vertical bitewing for the same area ( experimental ). The radiographs will be processed digitally. All the x ray will be taken using the standard protection protocol.
Detailed description
The aims of this research are to determine if vertical bitewings will be more effective and more comprehensive for the diagnosis of caries and the level of alveolar bone loss than the horizontal bitewing technique for the patients at King Abdulaziz University over the age of 18. This is a cross sectional study. All the images in this study will be conducted at School of Dentistry, King Abdulaziz University. Each patients will be exposed to 4 horizontal bitewing for posterior teeth ( standard of care ) and 4 vertical bitewing for the same area ( experimental ) . X ray will be taken using a film holder and a steel wire (3mm ) on the film holders. This steel wire will help to adjust for magnification later on. The x ray tube will be in the same distance (4mm from the x ray). The bitewing radiographs will be taken with double-packed Ekta speed Plus films on a radiograph machine operating at 70 kilovolt peak and 8 milliampere, having 2.5 aluminium filtration and a 0.860.8 mm focal spot, according to the manufacturer's exposure recommendations, with the parallel technique to obtain an accurate x ray as much as possible . The radiographs will be processed digitally. All the x ray will be taken using the standard protection protocol.
Interventions
RADIATIONBitewing X ray
Each patients will be exposed to 4 horizontal bitewing for posterior teeth ( standard of care ) and 4 vertical bitewing for the same area ( experimental ) . X ray will be taken using a film holder and a steel wire (3mm ) on the film holders. This steel wire will help to adjust for magnification later on. The x ray tube will be in the same distance (4mm from the x ray). The bitewing radiographs will be taken with double-packed Ekta speed Plus films on a radiograph machine operating at 0 kilovolt peak and 8 milliampere, having 2.5 aluminium filtration and a 0.860.8 mm focal spot, according to the manufacturer's exposure recommendations, with the parallel technique to obtain an accurate x ray as much as possible . The radiographs will be processed digitally. All the x ray will be taken using the standard protection protocol .
Sponsors
King Abdulaziz University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
1. Be at least 18 years of age. 2. Patients who are currently be treated KAU dental clinics and meet all medical and dental requirements of the KAU clinic for treatments (e.g., subjects with no diseases contraindicating their dental treatment at KAU). 3. Display no evidence of acute periodontal infection: e.g., abscess, suppuration, severe swelling and/or spontaneous bleeding that required urgent treatment 4. Non-smoker. 5. Patients who have opposing teeth and no missing posterior or canine teeth in all quadrants (except third molars).
Exclusion criteria
1. Have any known disease and would not allow the patient to be treatment planned for any procedures in the KAU clinics (e.g., severe anemia, low white blood cell count (Absolute Neutrophil Count (ANC) less than 1500, bleeding or coagulation disorder, uncontrolled hypertension (150/90), recent myocardial infarction (within 6 months of enrollment), diabetes (HbA1C ≥7%), HIV/AIDS (self-reported), history of or currently undergoing head and neck radiation, history of or currently taking bisphosphonates, endocrine-induced bone diseases (e.g. hyperparathyroidism), immunosuppressive therapy). 2. Have limited mental capacity and unable to give informed consent. 3. Be a pregnant or lactating female (self-reported) 4. Have untreated malignant neoplasm. 5. Individuals opposed to participate in the study. 6. If a patient has a crown which will not be able to assess the caries boarder and cementoenamel junction. 7. if a patient has a gagging reflex or inability to open his/her mouth. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Caries Detection | baseline and 15 minutes | Count number of teeth with caries |
| Level of Bone Loss | baseline and at 15 minutes | All of the bitewing radiographs will be evaluated for bone loss measurements. The steel wire will be used to determine the magnification factor . The steel wire and cemento enamel junction (CEJ) - if not obscure by caries - will be used as reference points for bone loss measurements. Each tooth will be measured from the CEJ to the bone crest. |
Countries
Saudi Arabia
Participant flow
Recruitment details
20 patients were screened for eligibility at the dental clinic
Pre-assignment details
20 participants were randomized.
Participants by arm
| Arm | Count |
|---|---|
| Experimental: Vertical Bitewing, Then Horizontal Bitewing Participants first received vertical bitewing. After a washout period of 15 min, they then received Horizontal bitewing. | 10 |
| Experimental: Horizontal Bitewing, Then Vertical Bitewing Participants first received horizontal bitewing. After a washout period of 15 min, they then received vertical bitewing. | 10 |
| Total | 20 |
Baseline characteristics
| Characteristic | Experimental: Vertical Bitewing, Then Horizontal Bitewing | Experimental: Horizontal Bitewing, Then Vertical Bitewing | Total |
|---|---|---|---|
| Age, Continuous | 34.05 Years STANDARD_DEVIATION 9.79 | 25.74 Years STANDARD_DEVIATION 12.83 | 29.9 Years STANDARD_DEVIATION 11.6 |
| Number of radiography | 5.9 x ray STANDARD_DEVIATION 1.7 | 5.3 x ray STANDARD_DEVIATION 1.3 | 5.6 x ray STANDARD_DEVIATION 1.5 |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Sex: Female, Male Female | 6 Participants | 8 Participants | 14 Participants |
| Sex: Female, Male Male | 4 Participants | 2 Participants | 6 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 20 | 0 / 20 |
| other Total, other adverse events | 0 / 20 | 0 / 20 |
| serious Total, serious adverse events | 0 / 20 | 0 / 20 |
Outcome results
Primary
Caries Detection
Count number of teeth with caries
Time frame: baseline and 15 minutes
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Vertical Bitewing | Caries Detection | 7.22 teeth |
| Horizontal Bitewing | Caries Detection | 6.48 teeth |
Primary
Level of Bone Loss
All of the bitewing radiographs will be evaluated for bone loss measurements. The steel wire will be used to determine the magnification factor . The steel wire and cemento enamel junction (CEJ) - if not obscure by caries - will be used as reference points for bone loss measurements. Each tooth will be measured from the CEJ to the bone crest.
Time frame: baseline and at 15 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vertical Bitewing | Level of Bone Loss | 1.15 mm of bone loss | Standard Deviation 0.69 |
| Horizontal Bitewing | Level of Bone Loss | 1.12 mm of bone loss | Standard Deviation 0.63 |