Evaluation of three radiographic methods for detecting occlusal caries lesions|
Pereira, Antonio Carlos; Eggertsson, Hafsteinn; Moustafa, Analoui; Zero, Domenick T.; Eckert, George J. & Mialhe, Fábio Luiz
To compare, in vitro, the performance of three radiographic methods for the detection of occlusal caries in
A total of 96 extracted molars with no apparent occlusal cavitation were selected,
they were photographed and radiographed under standardized conditions using conventional E-plus films and
two digital systems, CDR and Sidexis. Two examiners analyzed all films and images, recording the presence and
lesion depth. One quarter of the teeth were re-examined for intra- and interexaminer agreements. The teeth were
subsequently bisected and examined under a stereomicroscope. The intra and interexaminer agreements and
the diagnostic performance (sensitivity, specificity, accuracy and the area under receiver operating characteristic,
ROC curve) of each method were evaluated.
Out of 96 occlusal surfaces, 41 were sound, 31 had lesions in
enamel, and 24 had dentin lesions. Weighted Kappa values for intraexaminer agreement varied widely, depending
on both the observer and method. The interexaminer agreement was higher for the digital images than for the
conventional films. The area under the ROC curve for enamel and dentin caries (at D1 diagnostic threshold) was
0.55 for films, 0.60 for Schick and 0.54 for Sirona, which were not significantly different from each other.
Digital images presented better results of interexaminer agreement; however, no additional effect in the
diagnostic performance could be observed in comparison to conventional films.
digital radiography, dental caries, ROC curve, diagnostic test