**1. Introduction**

180 Contemporary Approach to Dental Caries

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saliva properties, caries prevalence and potential lesion activity in an adult UK population. *Journal of Dentistry*, Vol. 36 No. 4 (April 2008), pp 294-299, ISSN 0300Detection of carious lesions is prerequisite to an optimal preventive and minimal surgical intervention strategy. Radiographs are the most accurate diagnostic aid available for the detection of alveolar osseous abnormalities and dental disease progression (Russel & Pitts, 1993; Rothman, 1998). The development of digital radiography (radiovisiographs-RVG) has created new options in dentistry (Hedrick et al., 1994; Svanæs et al., 2000; Van der Stelt, 2005). However, imaging systems used in dentistry are largely limited to 2 dimensional (2- D) systems in including conventional-based radiography and digital radiography. The problem inherent to 2-D system is that 3 dimensional anatomy is collapsed into 2-D space, resulting in the superimposition of structures that potentially obscure features of interest and decrease diagnostic sensitivity. There are a number of 3-D systems available, like computed tomography (CT), tuned aperture computed tomography (TACT), and cone beam computed tomography (CBCT) (Hedrick et al., 1998; Mozzo et al., 1998; Sukovic, 2003; Aranyarachkul et al., 2005; Walker et al., 2005).

The CBCT technique presents an innovation of tomographic imaging systems and subsequent volumetric image reconstruction for dentistry. When compared with other methods of tomographic imaging, CBCT is characterized by rapid volumetric image acquisition from a single low radiation dose scan of the patient. CBCT, also known as true volumetric computed tomography (TVCT) designed for use in dental imaging of osseous structures has been introduced (Rothman, 1998; Mozzo et al., 1998; Schulze et al., 2005). The first available and now well-established CBCT system, the NewTom is an example of such a CBCT machine dedicated to dental and maxillofacial imaging, particularly for surgical and/or prosthetics implant planning in the field of dentistry. The NewTom differs from a traditional dental CT scan in the way it captures an image; it does so by cone beam volumetric tomography. The W-ray tube revolves around the patient's head in a single spiral, capturing a volume with each of the 360 degrees it rotates. Added together, the volumetric cone images are reformatted without any discernible error. In fact, the NewTom is accurate to 0.1 mm. While a dental CT scan takes ten minutes of working time and exposes the patient to two minutes of radiation, the NewTom scan takes 70 seconds and exposes the patient to 17 seconds of low-dose radiation. The radiation from a NewTom scan

Volumetric Tomography in Determination the Caries 183

2.3 2.5 2.6 2.4 3.3 3.3 3.5 3.2 4.8 4.9 5.0 4.7 4.4 4.5 4.7 4.3 2.6 2.6 2.5 2.3 3.0 3.1 3.3 3.0 4.4 4.5 4.4 4.2 4.8 4.9 5.1 4.7 3.5 3.5 3.6 3.3 2.0 2.1 2.2 2.0 4.1 4.0 4.2 3.8 4.3 4.4 4.6 4.2 3.2 3.1 3.3 3.0 3.0 3.1 3.2 2.8 4.0 4.1 4.1 3.8 3.6 3.7 3.8 3.5 3.8 3.8 3.9 3.6 4.3 4.2 4.4 4.1 4.7 4.8 4.7 4.2 4.6 4.8 4.9 4.6 2.3 2.4 2.6 2.3 2.5 2.5 2.7 2.4 2.7 2.9 2.9 2.8 3.6 3.8 3.7 3.5 4.4 4.6 4.8 4.1 3.6 3.7 3.9 3.8 2.1 2.3 2.3 2.0 4.3 4.0 4.4 4.1 3.0 3.3 3.5 3.2 2.7 2.9 3.0 2.5 3.1 3.2 3.4 3.0 4.0 4.1 4.3 3.8 3.5 3.5 3.7 3.3 2.6 2.7 2.7 2.7 2.8 2.6 2.9 2.5 4.2 4.3 4.4 4.0 3.3 3.4 3.6 3.2 3.5 3.7 3.9 3.4 4.0 4.2 4.4 3.9 3.8 3.3 3.5 4.0 2.7 2.6 2.7 4.1 1.8 2.0 2.1 4.2 1.4 1.7 1.5 4.3 2.3 2.3 2.5 4.4 *\*(Bland-Altman analysis: Radiographic-histologic: 93.2%, RVG-histologic and Volumetric-histologic: 90.9%)*  Table 1. Carious lesion depths (mm) measured linearly in software and histologically.

**Radiographic RVG Volumetric CT Histologic** 

**Tooth No** 

is comparable to the radiation from a single Panorex, while a dental CT scan is roughly equivalent to 6-8 times that amount, depending on bone density.

It is also possible to detect the relationship of the caries lesions with pulp chamber as 3-D. Therefore, the superpositions were eliminated with this system. The aim of this study was to compare the new dental volumetric tomography, RVG and conventional radiography in determination of the depth of approximal carious lesions.
