The aim of this study was to compare the accuracy of conventional film radiographs, digitized radiographs, and RadioVisioGraphy (RVG) for the detection of dentinal caries in occlusal surfaces of noncavitated extracted teeth. Eighty-one fully erupted extracted third molars were assessed by four observers using five radiographic methods: conventional film radiographs, digitized radiographs with contrast enhancement and with a filtering procedure, and RVG with contrast enhancement and with x function. Scoring criteria were dichotomous. Histologic sections (500 to 600 microns thick) served as the validation criterion. The two digital methods with contrast enhancement tended to perform more accurately than, although not significantly different from, the other three methods (p greater than 0.05). Average likelihood ratios (true positive/false positive) were 4.3 (conventional film radiographs), 4.4 (RVG with contrast enhancement), 3.6 (RVG with x function), 4.9 (digitized radiographs with contrast enhancement), and 3.7 (digitized radiographs with filtering procedure). Observers 1 and 2 (oral radiologists) performed better than observers 3 and 4 with all five methods (p less than 0.005).
[Show abstract][Hide abstract] ABSTRACT: This laboratory study compared visual-tactile examination with conventional radiographs, digital radiographs, and laser fluorescence in the detection of occlusal occult caries on extracted premolar teeth.
Extracted premolars without obvious caries or restorations were collected from school dental clinics. Occlusal surfaces of 320 extracted premolars were examined visually with an explorer, then examined using the KaVo Diagnodent unit and scored using specific criteria. The teeth were exposed using conventional and digital radiography, respectively. The radiographs were assessed for dentin radiolucencies beneath the occlusal surface.
Of the 320 teeth used in this study, 302 were scored as sound by visual-tactile examination. Of these, 57 (19%) demonstrated dentin radiolucency on conventional bite-wings, and 245 (81%) were scored as radiographically sound. Thus, the sensitivity and specificity values of the visual-tactile examination compared with conventional radiography were 81% and 44%, respectively. In contrast, Diagnodent produced results of 82% sensitivity and 36% specificity when compared with conventional radiography. When compared to digital radiography, the sensitivity and specificity values of the visual-tactile examination were 90% and 44%, respectively. In contrast, when compared to digital radiography, Diagnodent showed a very low specificity of only 32%, although sensitivity was still high at 91%. Differences in specificity among the techniques were statistically significant (P < .03), whereas differences in sensitivity were not (P > .01).
Although the diagnosis of occult dentinal caries may be further enhanced by the Diagnodent, a combination of visual-tactile examination and either conventional or digital radiography should identify over 80% of lesions.
[Show abstract][Hide abstract] ABSTRACT: Dental insurance carriers frequently require referral of radiographs for determination of prior approval. Radiographs are also often used for obtaining expert opinions before finalizing diagnoses and establishing treatment plans. Traditionally, such referrals have been carried out using the original or duplicate films transmitted through the postal system. Studies concerning alternative communication media for data transmission are presented, namely, the use of switched-digital telephone lines and of electronic mail networks.
Annals of the New York Academy of Sciences 01/1993; 670:269-76. DOI:10.1111/j.1749-6632.1992.tb26097.x · 4.38 Impact Factor
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