Evaluation of the effects of different bracket types on the detection of interproximal enamel caries using periapical radiography

Abstract

Aim: During orthodontic treatment, dental materials can affect the imaging of caries lesions. Material density and X-ray beam attenuation play important roles in this imaging. This study aims to evaluate the artifacts that are caused by brackets made of different materials and affect the visibility of International Caries Detection and Assessment System (ICDAS) code 5 caries. Methodology: One premolar tooth with ICDAS code 5 caries was examined. Eight periapical radiographs were taken: one without a bracket and seven with different types of brackets (composite with metal slot, self-ligating ceramic, monocrystalline ceramic, polycrystalline ceramic, zirconium, self-ligating stainless steel, and conventional stainless steel). The gray values of the caries region were evaluated using Fiji software (version 1.53f, National Institutes of Health, USA) on periapical radiographs. Results: Conventional stainless steel and self-ligating stainless steel brackets increased the radiopacity of the outer half of the enamel (E1). When these brackets were present, the gray values changed by -13.63633 (p = .026) and - 16.38967 (p = .006), respectively. There was no statistically significant difference in column B due to the brackets. However, numerically, the gray value changes were similar to those in column A. Conclusion: Orthodontic brackets affect the evaluation of periapical images. Ceramic brackets provide more advantages than stainless steel brackets for radiographic imaging.