The Efficiency of CBCT X-Ray in Detecting Caries Under Cemented and Uncemented Dental Fixed Prosthesis

Aim: This study aims to assess the efficiency of cone-beam computed tomography (CBCT) in detecting secondary caries under various types of fixed prostheses, including zirconia, e-max, porcelain-fused-to-metal, and acrylic CAD/CAM, and to evaluate whether dental cement acts as a barrier to caries detection. Materials and Methods: An in vitro experimental study was conducted using 116 caries-free human premolar teeth, divided into four main groups based on the type of fixed prosthesis. Each group was further subdivided according to caries depth (0-1 mm, 1-2 mm, 2-3 mm). A pilot study was performed to establish the methodology, followed by CBCT imaging before and after cementation with glass ionomer cement. The images were analyzed using Ez3D-I software, and data were statistically evaluated using SPSS software. Results: Significant differences in caries detection rates were observed before and after cementation for zirconia (100% to 58.33%, p = 0.002) and porcelain-fused-to-metal crowns (100% to 66.67%, p = 0.005). No significant differences were found for acrylic CAD/CAM and empress crowns. The study demonstrated excellent intraobserver reliability for caries and composite measurements. Conclusion: CBCT is an effective tool for detecting secondary caries under cemented and uncemented dental fixed prostheses, particularly for zirconia and porcelain-fused-to-metal crowns. Early detection of secondary caries is crucial for preserving tooth structure and improving treatment outcomes. Given its non-invasive nature and superior imaging capabilities, CBCT should be integrated into clinical practice for enhanced diagnostic accuracy.