Evaluation of the marginal adaptation and gingival status of full-crown restorations using an intraoral camera

Abstract

Objective: The purpose of this study was to compare the usefulness of intraoral photographs, acquired with a household intraoral camera operating in conventional, calibrated, and polarized modes, with clinical examinations for assessing the marginal adaptation and gingival status of full-crown restorations.

Methods: Clinical examinations were performed by a prosthodontist who classified the marginal adaptation of full-crown restorations according to FDI World Dental Federation criteria, and a periodontal expert who classified gingival status according to the Modified Gingival Index (MGI). The margins and gingival status of the conventional, calibration, and polarization groups of full-crown restorations were independently assessed by three evaluators who obtained photographs using an intraoral camera. Cases where at least two of three assessors were in agreement were analyzed using Cohen's kappa coefficient and the chi-square test, and the sensitivity and specificity were calculated.

Results: The conventional, calibration, and polarization groups differed significantly in marginal and gingival status of full-crown restorations. In the calibration group, there was good agreement between the camera-based and oral clinical examinations in terms of the gingival status of full-crown restorations (kappa = 0.945), with 100% sensitivity and 91.67% specificity; this was also the case in the polarization group with respect to the margins of full-crown restorations (kappa = 0.917, sensitivity = 97.22%, specificity = 94.44%).

Conclusions: An intraoral camera with black and white calibrated images is useful to assess the gingival status of full-crown restorations. Polarization mode can be used to assess the marginal adaptation of full-crown restorations. The camera is a feasible and valid diagnostic aid.

Keywords: Dental; Dental restorations; Diagnosis; Digital photography.

Fig. 1

Photographs from the conventional, calibration, and polarization groups obtained using an intraoral camera. The photographs were classified into conventional (A/D/G), calibration (B/E/H), and polarization (C/F/I) groups (A/B/C, full-crown restorations with clinically acceptable margins and clinically unacceptable gingival status; D/E/F full-crown restorations with clinically acceptable margins and gingival status; G/H/I full-crown restorations with clinically unacceptable margins and gingival status)