Evaluation of conventional and digital radiography capacities for distinguishing dental materials on radiograms depending on the present radiopacifying agent

Djordje Antonijević; Dragan Ilić; Vesna Medić; Slobodan Dodić; Kosovka Obradović-Djuričić; Zoran Rakočević

doi:10.2298/4272

Djordje Antonijević Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Dragan Ilić Department of Restorative Dentistry and Endodontics,Faculty of Dentistry, University of Belgrade, Belgrade, Serbia
Vesna Medić Department of Prosthodontics, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia
Slobodan Dodić Department of Prosthodontics, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia
Kosovka Obradović-Djuričić Department of Prosthodontics, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia
Zoran Rakočević Department of Radiology, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/4272

Keywords: radiography, dental, digital, contrast media, dental cements,

Abstract

Bacgroun/Aim. The radiopacity of an endodontic material can considerably vary as measured on film and a digital sensor. Digital radiography offers numerous advantages over convential film-based radiography in dental clinical practice regarding both diagnostic capabilities and postintervention procedures. The aim of this study was to investigate the capacity of conventional and charge-conpled device (CCD) based digital radiography to detect material on radiograph depending on the radio-pacifying agent present in the material. Methods. Experimental cements were formulated by mixing Portland cement with the following radiopacifying agents: zinc oxide (ZnO), zirconium oxide (ZrO₂), titanium dioxide (TiO₂), barium sulphate (BaSO₄), iodoform (CHI₃), bismuth oxide (Bi₂O₃) and ytterbium trifluoride (YbF₃). In addition, 5 endodontic materials comprising Endomethasone^®, Diaket^®, N₂^®, Roth 801^® and Acroseal^® were investigated to serve as control. Per three specimens of each material were radiographed alongside an aluminum step wedge on film (Eastman Kodak Company^®, Rochester, NY) and a CCD-based digital sensor (Trophy Radiologie^®, Cedex, France). Radiopacity values were calculated by converting the radiographic densities of the specimens expressed as a mean optical densities or mean grey scale values into equivalent thickness of aluminum. Results. Two-way ANOVA detected no significant differences with respect to the imaging system (p > 0.05), but the differences were significant with respect to radiopacifier (p < 0.001) and the interaction of the two factors (p < 0.05). Paired t-test revealed significant differences between the methods used for pure Portland cement, all concentrations of BaSO₄ and CHI₃, 10% and 20% additions of ZrO₂ and Bi₂O₃ and 10% and 30% addition of YbF₃ (p < 0.05). Conclusion. The materials which incorporate CHI₃ or BaSO₄ as radiopacifying agents are expected to be significantly more radiopaque on a digital sensor than on film. During clinical practice one should concern to the quality of contrast assessement obtained by digital according to conventional radiography.

References

Beyer-Olsen EM, Orstavik D. Radiopacity of root canal sealers. Oral Surg Oral Med Oral Pathol 1981; 51(3): 320−8.

Santos SM, Soares JA, Costa GM, Brito-Júnior M, Moreira AN, Magalhães CS. Radiographic parameters of quality of root canal fillings and periapical status: a retrospective cohort study. J Endod 2010; 36(12): 1932−7.

Bodanezi A, Munhoz Ede A, Bernardineli N, Capelozza AL, de Moraes IG, Bramante CM. Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids. Braz Dent J 2010;21(2): 142−7.

Williams JA, Billington RW. A new technique for measuring the radiopacity of natural tooth substance and restorative materi-als. J Oral Rehabil 1987; 14(3): 267−9.

Watts DC. Radiopacity vs. composition of some barium and strontium glass composites. J Dent 1987; 15(1): 38−43.

American National Standard Institute. Specification No. 57, En-dodontic sealing materials. New York, NY: American Dental Association; 2000.

International Organization for Standardization. ISO 6876, Dental root canal sealing materials. 2nd ed. Geneva: ISO; 2001.

Tagger M, Katz A. Radiopacity of endodontic sealers: develop-ment of a new method for direct measurement. J Endod 2003; 29(11): 751−5.

Gu S, Rasimick B, Deutsch A, Musikant B. Radiopacity of dental materials using a digital X-ray system. Dent Mater 2006; 22(8): 765−70.

ISO 4049: Polymer based restorative, filling and luting materi-als. Geneva, Switzerland: ISO; 2009.

Rasimick BJ, Shah RP, Musikant BL, Deutsch AS. Radiopacity of endodontic materials on film and a digital sensor. J Endod 2007; 33(9): 1098−101.

Carvalho-Junior JR, Correr-Sobrinho L, Correr AB, Sinhoreti MA, Consani S, Sousa-Neto MD. Radiopacity of root filling materials using digital radiography. Int Endod J 2007; 40(7): 514−20.

Taşdemir T, Yesilyurt C, Yildirim T, Er K. Evaluation of the ra-diopacity of new root canal paste/sealers by digital radiogra-phy. J Endod 2008; 34(11): 1388−90.

Baksi BG, Sen BH, Eyuboglu TF. Differences in aluminum equivalent values of endodontic sealers: conventional versus digital radiography. J Endod 2008; 34(9): 1101−4.

Bodrumlu E, Sumer AP, Gungor K. Radiopacity of a new root ca-nal sealer, Epiphany. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(5): e59−61.

Sabbagh J, Vreven J, Leloup G. Radiopacity of resin-based mate-rials measured in film radiographs and storage phosphor plate (Digora). Oper Dent 2004; 29(6): 677−84.

Pontual AA, de Melo DP, de Almeida SM, Bóscolo FN, Haiter Neto F. Comparison of digital systems and conventional dental film for the detection of approximal enamel caries. Dentomaxillofac Radiol 2010; 39(7): 431−6.

Tofangchiha M, Bakhshi M, Fakhar HB, Panjnoush M. Conven-tional and digital radiography in vertical root fracture diagno-sis: a comparison study. Dent Traumatol 2011; 27(2): 143−6.

Radel RT, Goodell GG, McClanahan SB, Cohen ME. In vitro ra-diographic determination of distances from working length files to root ends comparing Kodak RVG 6000, Schick CDR, and Kodak insight film. J Endod 2006; 32(6): 566−8.

Rakocevic Z. Physics of ionized radiation. In: Zoran Rakočević, Dragana Mratinković, Branko Vukov, editors. Elements of radi-ology of dentomaxillofacial region. Belgrade: School of Den-tistry; 1998. p. 15−8. (Serbian)

Grassl U, Schulze RK. In vitro perception of low-contrast fea-tures in digital, film, and digitized dental radiographs: a receiver operating characteristic analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(5): 694−701.

Húngaro Duarte MA, de Oliveira El Kadre GD, Vivan RR, Guerri-erio Tanomaru JM, Tanomaru Filho M, de Morales IG. Radiopacity of portland cement associated with different radiopacifying agents. J Endod 2009; 35(5): 737−40.

Bortoluzzi EA, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Duarte MA. Radiographic effect of different radiopacifiers on a po-tential retrograde filling material. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(4): 628−32.

Saliba E, Abbassi-Ghadi S, Vowles R, Camilleri J, Hooper S, Camilleri J. Evaluation of the strength and radiopacity of Portland cement with varying additions of bismuth oxide. Int Endod J 2009; 42(4): 322−8.

Gaur TG. An in-vitro evaluation of radiopacity of four endo-dontic sealers using conventional and digital radiography. Asian J Oral Health Allied Sci 2011; 1: 67−70.

Tanomaru-Filho M, Jorge EG, Tanomaru JM, Gonçalves M. Evalua-tion of the radiopacity of calcium hydroxide- and glass-ionomer-based root canal sealers. Int Endod J 2008; 41(1): 50−3.

Camilleri J, Gandolfi MG. Evaluation of the radiopacity of cal-cium silicate cements containing different radiopacifiers. Int Endod J 2010; 43(1): 21−30.

Camilleri J. Characterization of hydration products of mineral trioxide aggregate. Int Endod J 2008; 41(5): 408−17.

Camilleri J. The physical properties of accelerated Portland ce-ment for endodontic use. Int Endod J 2008; 41(2): 151−7.

Coomaraswamy KS, Lumley PJ, Hofmann MP. Effect of bismuth oxide radioopacifier content on the material properties of an endodontic Portland cement-based (MTA-like) system. J En-dod 2007; 33(3): 295−8.

Camilleri J. Hydration mechanisms of mineral trioxide aggre-gate. Int Endod J 2007; 40(6): 462−70.