Differences in Radiopacity Value of RMGIC, GIC and Composite

Resin Materials with Secondary Caries using Conventional and

Digital Radiography

Cek Dara Manja

, Kholidina Imanda Harahap

Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia

Department of Dental Material and Technology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia

Keywords: Radiopacity, Materials, Secondary Caries, Conventional Radiography, Digital Radiography

Abstract: Radiopacity is an important feature of the restorative material because the ability of the dentist differs in

interpreting a lesion or caries on a radiograph. The purpose of this study is to determine the differences in

radiopacity value of RMGIC, GIC and bulkfill composite resin materials with secondary caries as well as to

evaluate the radiographic technique used to obtain the radiograph. This type of research is descriptive

analytics by using comparative group design. The samples in this study were dental radiographs filled with

RMGIC, GIC and bulkfill composite resin materials produced from conventional and digital radiographic

sampling. Then conventional and digital radiographs are measured using Image J software to distinguish the

respective radiopacity of restoration materials and secondary caries. Using RMGIC average restorative

materials on conventional radiographs of 191,226 ± 17,908 and on digital radiographs of 187.490 ± 11.734.

Using the average GIC restoration material on conventional radiographs of 191,063 ± 52,527 and on digital

radiographs of 186,809 ± 15,663. Using a bulkfill resin composite resin on average radiopacity on a

conventional radiograph of 177.960 ± 39.147 and on a digital radiograph of 192.293 ± 11.704. The mean

secondary caries radiodencity on conventional radiographs was 195,651 ± 10,191 and the digital radiograph

was 104,293 ± 15,114. Furthermore, the data were analyzed by using T test with significance value p <0,05.

There was no significant difference in radiopacity value of RMGIC, GIC and bulkfill composite resin

materials on secondary caries using conventional radiography. There are significant differences in the

radiopacity value of RMGIC, GIC and bulkfill composite resin materials on secondary caries using digital

radiography.

1 INTRODUCTION

Radiopacity is a physical property of restorative

materials that have no specific standard for use in

dental restorations I and II (ISO, 2000).

Manufacturers of ingredients add radiopacity

ingredients to the dental resins. Adequate radiation

will make the material distinguishable from enamel

and dentin tissue on the radiograph so as to facilitate

the dentist in diagnosing secondary caries.

Radiopacity of resin material is related to the

percentage of barium, strontium and zirconia content

in volume or weight (Power JM, 2006).

The thickness of the material also affects the

radiopacity of the radiograph. By considering the

system used, there is a significant relationship

between the type of material used and the diagnosis.

(Pedrosa, 2011).

The presence of restorative materials may affect

the diagnosis of a carious lesion on a radiograph.

Enforcement of secondary caries diagnoses is a

challenge for dentists because they are often fooled

by low-radiation-grade restorations. On radiography,

to be able to diagnose the presence of secondary

caries, several factors can affect such a close distance

between lesions with restoration, size and orientation

of the lesion and geometry and projection (Nair MK,

2001).

By using a charge coupled divice (CCD) and with

a phosphor plate, the secondary caries image looks

similar, but when contrast and brightness are

increased it is superior to the image obtained with the

phosphor plate without additional( Nair MK, 2001).

The aim of this study was to evaluate conventional

and digital radiographs in assessing the radiopacity

of GIC restoration materials and bulkfill composite

568

Manja, C. and Harahap, K.

Differences in Radiopacity Value of Rmgic, Gic and Composite Resin Materials with Secondary Caries using Conventional and Digital Radiography.

DOI: 10.5220/0010078505680571

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

568-571

ISBN: 978-989-758-449-7

resins to distinguish them from secondary caries

features.

2 METHODOLOGY

This type of research is descriptive analytics by using

comparative group design. The study was conducted

in dental practice, Pramitha clinic

laboratory and dental radiology clinic hospitals

teeth and mouth University of Sumatera Utara. The

samples in this study were dental radiographs that

had been restored with RMGIC, GIC and bulkfill

composite resin materials and obtained from

conventional and digital radiography systems.

Inclusion criteria were a) conventional and digital

radiographs with details and contrast of teeth clearly

visible from the occlusal surface to the root tip, b) for

secondary caries, visible radiolucent images under

the fillings. Exclusion criteria are conventional and

digital radiographs that are blurred and experience

cone cutting. A sample size of 18 divided into six

groups, each group consisting of three radiographs,

namely:

1. Group of conventional dental radiographs

restored with RMGIC.

2. Group of conventional dental radiographs

restored with GIC.

3. Group of conventional dental radiographs

restored with bulkfill composite resins.

4. Group of digital dental radiographs restored with

RMGIC.

5. Group of digital dental radiographs restored with

GIC.

6. Group of digital dental radiographs restored with

bulkfill composite resins.

Assessment of the radiopacity of conventional

radiograph groups using the indirect method of

conventional radiographs scanned and digital

photographs was obtained. The radiopacity

assessment of the digital radiograph group uses a

direct method where an optical density value is

directly obtained by using a direct photo analysis.

Assessment of radiopacity of GIC, bulkfill

composite resin and RMGIC restoration Material

and secondary caries radiodensity using Image J

software by:

Choosing a radiograph that will be analyzed, then

giving a sign to the restoration area and secondary

caries found on the tooth.

1. Open the Analyze menu and select the Histogram

menu.

2. The mean value and standard deviation will come

out computerized.

3. Calculate the average value for the entire

radiograph based on the restoration material and

the radiographic technique used.

Furthermore, a comparison of each restoration

material with secondary caries was used using T test

analysis to see significant differences.

Figure 1. Digital radiograph with Class I restoration on 36.

Figure 2. Histogram analysis using Image J software.

Figure 3. Conventional radiograph with Class I restoration

on 36.

Figure 4. Histogram analysis using Image J software.

Differences in Radiopacity Value of Rmgic, Gic and Composite Resin Materials with Secondary Caries using Conventional and Digital

Radiography

569

Table 1: The average radiopacity value of restoration

material and radiodensity of secondary caries.

Table 2: Comparison of RMGIC and secondary caries with

conventional radiography.

Table 3: Comparison of GIC and secondary caries with

conventional radiography.

Table 4: Comparison of bulkfill composite resins and

secondary caries with conventional radiography.

Table 5: Comparison of RMGIC and secondary caries with

digital radiography.

Table 6: Comparison of GIC and secondary caries with

digital radiography.

Table 7: Comparison of bulkfill composite resins and

secondary caries with digital radiography.

3 DISCUSSION

Radiopacity of dentistry is very important to

distinguish the dental curing material with the tooth

tissue and its surroundings. Radiopacity is a property

needed for dental materials, including restorative

materials, cavities, core enhancers, adhesives,

adhesives for root canal fillers, temporary crowns,

bridges and ceramics (Anusavice KJ, 2013). Material

radiopacity will increase with increasing particles

containing high atomic number elements (Powers

JM, 2006).

Radiopacity of dentistry material is defined as the

value of optical density of a material (Candeiro,

2012). Factors that can influence the radiopacity of

dental materials are the thickness and chemical

composition of dental materials (Pekkan, 2016).

Another factor is the setting of exposure to light, X-

ray beam angulation, the distance of the film to the

light source and the exposure method used.

Radiopacity of the restoration material used does not

have sufficient radiopacity on the radiograph

including some glass ionomer cement, so the dentist

must know about it (Tsuge, 2009). Restorative

materials vary in radiographic appearance depending

on the thickness, density, atomic number and x-ray

energy rays used to make the radiograph (Eric, 2013).

The results showed that the RMGIC, GIC and

bulkfill composite resin materials using conventional

radiography had different radiopaquality values with

secondary but not significant caries. On conventional

radiographs it is difficult to distinguish the image of

restoration materials with secondary caries. Diagnosis

of secondary carious lesions seen using imaging is

influenced by the type of restoration material

(Antonijevic, 2014).

This may be due to factors such as variations in

the film positioning technique and X-ray rays can

greatly affect the picture of the carious lesion, the

lighting factor may produce marks that affect the

overall contrast of the radiograph thus affecting the

shape or size of the carious lesions on the radiograph

and the exact position of the carious lesion for

example buccal / lingual or caries expansion into

buko-lingual (Eric, 2013).

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

570

Another thing that can affect is the distance

between the caries lesion and the pulp horn where

these two shadows can be close together or even

visually interconnected but may not be in the same

plane. The presence of a carious lesion and the

density of the enamel top layer may obscure the

decalcification zone. The presence of secondary

caries and existing patches may coat thoroughly the

existing carious lesions causing errors in interpreting.

The imaging system affects the image of the

restoration. Restoration material with radiopacity is

greater than enamel, will be beneficial for true-

negative diagnosis (Antonijevic, 2014). The

radiopacity value of the restoration material which is

between the enamel and dentin values, or lower than

dentin, tends to create confusion in the test and is

susceptible to false positive diagnosis of secondary

carious lesions (Pedrosa RF, 2011).

The results showed that the RMGIC, GIC and

bulkfill composite resin materials using digital

radiography had significantly different

radiopaquality values with secondary caries. This is

probably because digital radiographs use detectors

that can show significant changes in how we acquire,

store, retrieve, and display images (White and

Pharaoh, 2009).

Digital detectors have the characteristics of

contrast resolution that is the ability to distinguish

radiographic image density and space resolution ie

the capacity to distinguish in detail (Gu, 2006). The

sensitivity of the detector has the ability to respond

to a small amount of radiation. The International

Organization for Standardization classifies the

sensitivity of intraoral films based on speed (ISO,

2000).

The usefulness of digital receptor sensitivity is

influenced by a number of factors including detector

efficiency, pixel size and noise system (White and

Pharaoh, 2009).

4 CONCLUSIONS

The conclusion of this study is that there is no

significant difference in radiopacity value of

RMGIC, GIC and bulkfill composite resin materials

on secondary caries using conventional radiography.

There are significant differences in radiopacity value

of RMGIC, GIC and bulkfill composite resin

materials on secondary caries using digital

radiography. It is better to conduct further research

using different restorative materials in the posterior

and anterior tooth regions.

ACKNOWLEDGEMENTS

This research was funded by the University of North

Sumatra in accordance with the TALENTA Research

Contract of the University of North Sumatra 2018

Fiscal Year Number: 2590 / UN5.1.R / PPM / 2018

dated March 16, 2018

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