Diş Çürüğü Tespitinde Radyolojinin Önemi
Synopsis
Diş çürükleri, dünya çapında en yaygın kronik hastalıklardan biri olup, erken teşhis edilmediğinde ağrı, enfeksiyon ve diş kayıplarına yol açabilen ciddi bir sağlık problemidir. Çürük teşhisi, hekimin klinik tecrübesinin yanı sıra klinik muayene ve radyolojik tetkiklerin birlikte yorumlanmasıyla gerçekleştirilir. Diş sert dokularında en az %30 oranında demineralizasyon meydana geldiğinde çürükler radyografik olarak tespit edilebilir hale gelir. Arayüz çürüklerinin erken tanısında ısırtma (bite-wing) radyografileri yüksek etkinlik gösterirken, oklüzal ve bukkal çürüklerin radyografik tespiti süperpozisyonlar nedeniyle daha fazla hassasiyet gerektirir. Günümüz diş hekimliğinde geleneksel filmlerin yerini alan dijital görüntüleme sistemleri; CCD, CMOS, düz panel dedektörler ve fosfor plak (PSP) sistemleri gibi farklı sensör teknolojilerini içermektedir. Dijital radyografi, konvansiyonel sistemlere kıyasla banyo işlemlerini ve kimyasal atıkları ortadan kaldırarak arşivleme kolaylığı sağlar ve maruz kalınan radyasyon dozunu %50-80 oranında azaltarak hasta güvenliğini artırır. Son dönemde gelişen Konik Işınlı Bilgisayarlı Tomografi (KIBT) teknolojisi ise oklüzal ve aproksimal kavitasyonlu çürüklerin tespitinde etkin bir alternatif sunsa da, radyasyon dozu ilkeleri gereği rutin bir yöntem olarak değerlendirilmemektedir. Sonuç olarak, efektif bir tedavi planlaması için radyografik bulguların mutlaka titiz bir klinik muayene ile harmanlanması gerekmektedir.
Dental caries is one of the most common chronic diseases worldwide, and if not diagnosed early, it is a serious health problem that can lead to pain, infection, and tooth loss. Caries diagnosis is performed by interpreting clinical examination and radiological examinations together with the clinical experience of the physician. Caries can be radiographically detected when at least 30% demineralization occurs in dental hard tissues. While bite-wing radiographs show high efficiency in the early diagnosis of approximal caries, the radiographic detection of occlusal and buccal caries requires more precision due to superpositions. Digital imaging systems, which replace traditional films in modern dentistry, include different sensor technologies such as CCD, CMOS, flat panel detectors, and phosphor storage plate (PSP) systems. Compared to conventional systems, digital radiography eliminates processing procedures and chemical wastes, provides ease of archiving, and increases patient safety by reducing the radiation dose by 50-80%. Although Cone Beam Computed Tomography (CBCT) technology, which has developed recently, offers an effective alternative in detecting occlusal and cavitated approximal caries, it is not considered a routine method due to radiation dose principles. Consequently, for an effective treatment planning, radiographic findings must be combined with a meticulous clinical examination.
References
Yasin Gönder H, Mohammadi R, Harmankaya A, Burak Yüksel İ, Seda Gültekin D. Investigation of the Effects of Adhesive Materials of Different Types and Thicknesses on Dental Tissue Stress via FEM Analysis. BioMed Research International. 2022;2022:8493909.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye CJBotwho. The global burden of oral diseases and risks to oral health. 2005;83:661-9.
Mortensen D, Dannemand K, Twetman S, Keller MKJTodj. Detection of non-cavitated occlusal caries with impedance spectroscopy and laser fluorescence: an in vitro study. 2014;8:28.
KARABEKİROĞLU S, GÖNDER HY, ÇAYIR İ, Nimet ÜJNEÜDHD. Farklı Etiyolojik Faktörlerin Yüksek Çürük Riskli Genç Yetişkinlerde Çürük Deneyimi Üzerine Etkisi.2(3):103-12.
Balakrishnan M, Simmonds RS, Tagg JRJAdj. Dental caries is a preventable infectious disease. 2000;45(4):235-45.
ÇAKUR BJAÜDHFD. Diş çürüğü teşhisinde radyografik etkenler. 2010;2010(2):119-22.
Dove SBJJode. Radiographic diagnosis of dental caries. 2001;65(10):985-90.
Çakur B. Mandibular kemiğin kantitatif değerlendirilmesinde panoramik radyogramın dansitometre değerleri ile dual enerji x-ray absorpsiyometri değerlerinin karşılaştırılması. 2005.
Pitts NJDu. The diagnosis of dental caries: 1. Diagnostic methods for assessing buccal, lingual and occlusal surfaces. 1991;18(9):393-6.
Hintze H, Wenzel A, Jones CJCr. In vitro comparison of D-and E-speed film radiography, RVG, and visualix digital radiography for the detection of enamel approximal and dentinal occlusal caries lesions. 1994;28(5):363-7.
Pitts NJDR. The use of bitewing radiographs in the management of dental caries: scientific and practical considerations. 1996;25(1):5-16.
Akpata E, Farid M, Al-Saif K, Roberts EJCr. Cavitation at radiolucent areas on proximal surfaces of posterior teeth. 1996;30(5):313-6.
Mouyen F, Benz C, Sonnabend E, Lodter JPJOS, Oral Medicine, Oral Pathology. Presentation and physical evaluation of RadioVisioGraphy. 1989;68(2):238-42.
Direkt Sistemler CJTKJOMR-ST. İntraoral dijital görüntüleme sistemleri: Direkt sistemler, CCD, CMOS, düz panel dedektörler, indirekt sistemler, yarı direkt dijital görüntüleme, fosfor plak taramaları. 2016;2(2):4-9.
Benz C, Mouyen FJOs, oral medicine, oral pathology. Evaluation of the new RadioVisioGraphy system image quality. 1991;72(5):627-31.
Petrikowski CGJJotCDA. Introducing digital radiography in the dental office: an overview. 2005;71(9).
Brennan JJJoO. An introduction to digital radiography in dentistry. 2014.
Eisenberg RL. Radiology: an illustrated history: Mosby Incorporated; 1992.
Johnson ON, McNally MA, Essay CE. Essentials of dental radiography for dental assistants and hygienists: Pearson Prentice Hall; 2007.
Harorlı A, Akgül HM, Dağıstan S. Dişhekimliği Radyolojisi. 1.baskı. Erzurum: Eser Ofset Matbaacılık. 200621.
Soğur E, Akdeniz B G. Dişhekimleri ve dişhekimliği öğrencilerinin dijital radyografi hakkındaki bilgi, tutum ve davranışlarının değerlendirilmesi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi.2005;32:207-13
Haring JI, Jansen L. Dental radiography: principles and techniques: WB Saunders; 2000.
Ludlow J, Mol A. Digital Imaging In: White SC, Pharoah MJ. Oral Radiology. Principles and Interpretation. St. Louis Mosby. Elsevier; 2009.
Syriopoulos K, Sanderink G, Velders X, Van Der Stelt PJDR. Radiographic detection of approximal caries: a comparison of dental films and digital imaging systems. 2000;29(5):312-8.
Dhir P, David CM, Keerthi G, Sharma V, Girdhar VJIJoM, Sciences D. Digital imaging in dentistry: an overview. 2014:524-32.
Parks ETJTJotADA. Digital radiographic imaging: is the dental practice ready? 2008;139(4):477-81.
Paurazas SB, Geist JR, Pink FE, Hoen MM, Steiman HRJOS, Oral Medicine, Oral Pathology, Oral Radiology,, Endodontology. Comparison of diagnostic accuracy of digital imaging by using CCD and CMOS-APS sensors with E-speed film in the detection of periapical bony lesions. 2000;89(3):356-62.
Emmot LJDPR. Making sens of sensors a guide to choosing digital radiography sensors. 2002:36-8.
YELER DY, TAŞVEREN SK, KAYNAR OJAÜDHFD. Dişhekimliğinde dijital görüntüleme yöntemleri. 2006;2006(Supplement 1).
Sanderink G, Miles DAJDCoNA. Intraoral detectors. CCD, CMOS, TFT, and other devices. 2000;44(2):249-55, v.
Compton SM. Exercises in oral radiology and interpretation. Wiley Online Library; 2004.
Akdeniz GJAÜDHFD. Modern Imaging Modalities (II). 2000;27(2):271-6.
Hildebolt CF, Couture RA, Whiting BRJDCoNA. Dental photostimulable phosphor radiography. 2000;44(2):273-97.
Van Der Stelt PFJTJotADA. Filmless imaging: the uses of digital radiography in dental practice. 2005;136(10):1379-87.
Miles DAJDCoNA. Imaging using solid-state detectors. 1993;37(4):531-40.
Lim K, Loh E, Hong H, editors. QUANTITATIVE ASSESSMENT OF A NEW INTRAORAL DIGITAL IMAGING-SYSTEM. JOURNAL OF DENTAL RESEARCH; 1995: AMER ASSOC DENTAL RESEARCH 1619 DUKE ST, ALEXANDRIA, VA 22314.
Bedard A, Davis TD, Angelopoulos CJJCDP. Storage phosphor plates: how durable are they as a digital dental radiographic system. 2004;5(2):57-69.
Ergun S, Guneri P, Ilguy D, Ilguy M, Boyacıoglu HJDR. How many times can we use a phosphor plate? A preliminary study. 2009;38(1):42-7.
Diwakar N, Kamakshi SSJJoM, Radiology, Pathology, Surgery. Recent advancements in dental digital radiography. 2015;1(4):11-6.
Vandenberghe B, Jacobs R, Yang JJOS, Oral Medicine, Oral Pathology, Oral Radiology,, Endodontology. Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown. 2007;104(3):395-401.
Kayipmaz S, Sezgin ÖS, Saricaoğlu ST, Çan GJEjor. An in vitro comparison of diagnostic abilities of conventional radiography, storage phosphor, and cone beam computed tomography to determine occlusal and approximal caries. 2011;80(2):478-82.
Wenzel A, Hirsch E, Christensen J, Matzen L, Scaf G, Frydenberg MJDR. Detection of cavitated approximal surfaces using cone beam CT and intraoral receptors. 2013;42(1):39458105-.
Angnes G, Angnes V, Grande RHM, Battistella M, Loguercio AD, Reis AJBor. Occlusal caries diagnosis in permanent teeth: an in vitro study. 2005;19:243-8.
Mozzo P, Procacci C, Tacconi A, Tinazzi Martini P, Bergamo Andreis IJEr. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. 1998;8(9):1558-64.
Adibi S, Zhang W, Servos T, O’Neill PNJJode. Cone beam computed tomography in dentistry: what dental educators and learners should know. 2012;76(11):1437-42.
