Accuracy of dental calculus detection using digital radiography and image manipulation

Abstract

Background: The aim of this study was to determine if image enhancement improves a clinician's ability to identify the presence of calculus on digital radiographs. Methods: Seventy-one hopeless teeth were collected from 34 patients. Teeth were stained with 1% methylene blue, the largest interproximal calculus deposit was scored, and photographs of each interproximal root surface were taken. The surface area of calculus deposit was determined as a percentage of the total interproximal root surface area. Digital radiographs of teeth taken before extraction were modified using the following enhancements: auto-contrast, emboss, invert, and sharpen. Radiographic presence of calculus was determined by two examiners. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each examiner and enhancement. A receiver operating characteristic curve was used to compare differences between the image enhancements in the detection of dental calculus. The kappa statistic was used to compare ratings between examiners. Results: None of the enhanced images were statistically superior to original images in identifying radiographic calculus (P > 0.05). The average sensitivity of digital radiography was 50%, average specificity was 82.2%, PPV was 94%, and NPV 23.2%. A threshold of >30% of interproximal root surface covered with calculus and increasing size of deposits were associated with improved detection (P < 0.05). Conclusions: Digital enhancements do not significantly improve radiographic detection of dental calculus. As area of calculus on the root surface and size of calculus deposits increased, sensitivity of detection also increased. K E Y W O R D S dental calculus; periodontal diseases; prognosis; radiography, dental, digital 1 INTRODUCTION Dental calculus has long been studied in its connection with periodontal disease. Calculus is essentially calcified dental plaque comprised of mainly organic components attached to the tooth cuticle, root undercuts, and directly to the tooth surface 1,2 and acts as a plaque retentive feature. The presence of calculus extends the sphere of

Accuracy of end-on fluoroscopy in predicting implant position in relation to the vertebral canal in dogs

“…The value of gray-scale inversion has been controversially discussed in human medicine. While it improved nodule detection on chest radiography ( 22 ) and increased the sensitivity when assessing post-operative spinal orthopedic implants and osseous fusion on CT ( 23 ), it did not improve accuracy of dental calculus detection ( 24 ). The current literature suggests its use as an easy and useful adjunct when combined with conventional images ( 25 ).…”

Quality assessment of digital images produced using handheld X-ray equipment

“…Owing to delicate structures present in the stomatognathic system, such as periodontal bone (Abdinian et al, 2020;Hyer et al, 2021), periodontal bone level (Christiaens et al, 2018;Vandenberghe et al, 2011b;Restrepo-Restrepo et al, 2019), root canal (Vandenberghe et al, 2011a), dental calculus (Hyer et al, 2021;Christiaens et al, 2018;Vandenberghe et al, 2011b;Restrepo-Restrepo et al, 2019;Vandenberghe et al, 2011a;Joly et al, 2002), and the presence of different biomaterials along with the biological tissue (Hyer et al, 2021), the clinical conduct may be compromised (Cruz et al, 2014;Krupinski, 2017;Nejaim et al, 2016;Mah et al, 2011).…”