Radiographic detection of occlusal caries in noncavitated teeth. A comparison of conventional film radiographs, digitized film radiographs, and RadioVisioGraphy.
ABSTRACT 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).
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ABSTRACT: The purpose of this study was to compare the accuracy of diagnoses of occlusal caries lesions from digital images captured using a photostimulable phosphor (PSP) sensor under in vivo and in vitro conditions and to present useful clinical data regarding the clinical application of the system. The study sample comprised 60 mandibular third molars (30 sound and 30 with occlusal caries) requiring extraction. A pre-extraction and post-extraction image of each tooth were acquired using a PSP sensor. A stopwatch was used to record the time required for the clinical procedures. Patient comfort or discomfort during image acquisition was also recorded. Images were evaluated twice by three observers using a five-point scale. Kappa coefficients were calculated to assess intra- and interobserver agreement. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of each observer for both in vivo and in vitro images. The t-test was used to compare A(z) values, with a significance level set at 0.05 (alpha _ 0.05). The time required for clinical imaging procedures in patients who claimed discomfort and in those who did not was compared using the Mann-Whitney U-test. Intraobserver agreement was almost perfect, whereas interobserver agreement was fair to moderate. No statistically significant differences were found in the accuracy of diagnoses of occlusal caries lesions using in vivo and in vitro digital images. The median time needed for image exposure was 1.04 min and the median time needed to complete the image acquisition procedure was 1.45 min. The diagnosis of accuracy of occlusal caries lesions using in vivo and in vitro digital images yielded similar results.Dentomaxillofacial Radiology 01/2010; 39(1):17-22. · 1.15 Impact Factor
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ABSTRACT: The aims of the study were to compare subjective image quality of clinical images obtained with a storage phosphor plate (SPP)-based digital and conventional film-based panoramic system for the visualization of various anatomical structures and to evaluate the effect of various processing algorithms on image interpretation. Panoramic radiographs were taken in 42 patients both with film and with a SPP system. SPP images were treated with shadow, sharpen, negative, greyscale sigma and greyscale exponential filters. Four observers subjectively evaluated films and unfiltered and filtered SPP images for the visibility of anatomical structures with various radiodensities as well as for overall image quality on a three-point rating scale. The statistical methods used were Kruskal-Wallis, odds ratio analysis and Cohen's kappa. No statistically significant difference was found between film and unfiltered digital images except for low-contrast structures (P > 0.05). Film images were preferred for the visibility of low-contrast structures (P < 0.05). Best overall image quality was obtained with sharpened images (P < 0.05) followed by films and unfiltered digital images. Among all filtered images, sharpened ones received the highest ratings for the visibility of all anatomical structures (P < 0.05). The intra- and interobserver agreement ranged between moderate and substantial and between fair and moderate, respectively. Film and unfiltered SPP-based panoramic images performed equally well in terms of overall quality; however, films were best for the perception of low-contrast structures. The sharpening filter may be recommended for enhancing SPP panoramic images to improve the visual perception of most of the anatomical structures as well as overall quality.Dentomaxillofacial Radiology 10/2010; 39(7):424-30. · 1.15 Impact Factor
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ABSTRACT: The aim of this study was to compare the diagnostic quality of a new wireless handheld unit (ADX4000; Dexcowin Co. Ltd, Korea) on conventional bitewings and its LCD screen for the detection of approximal caries in primary teeth. In total, 108 approximal surfaces of primary teeth were examined in vitro by 3 observers. Conventional films were viewed under subdued lighting conditions on a conventional view box. Digital 3.5 inch images were displayed on the built-in monitor of the ADX4000 and digital 17 inch images were viewed on a 17 inch monitor. The true caries diagnosis was based on histological assessment of the approximal surfaces after sectioning the primary teeth. Receiver operating characteristic (ROC) curve (A(z)) analysis was used to assess the diagnostic quality of imaging modalities. The areas under the ROC curves ranged from 0.786 (digital 17 inch) to 0.813 (digital 3.5 inch). No statistically significant differences were found between the three modalities for detecting approximal caries. It was concluded that the diagnostic quality of conventional film and digital images, which were exposed and viewed by a new wireless handheld unit, was comparable.Dentomaxillofacial Radiology 02/2010; 39(2):91-4. · 1.15 Impact Factor