In vitro assessment of cone beam local computed tomography for proximal caries detection

107

Objective: The purpose of this study was to assess the in vitro diagnostic ability of visual inspection, film, charge-coupled device (CCD) sensor, photostimulable phosphor (PSP) sensor and cone beam CT in the detection of proximal caries in posterior teeth compared with the histological gold standard. Methods: Visual inspection, film, CCD, PSP and cone beam CT images were used to detect proximal caries in the mesial and distal surfaces of 138 teeth (276 surfaces). Visual inspection and evaluation of all intraoral digital and conventional radiographs and cone beam CT images were performed twice by three oral radiologists. Weighted kappa coefficients were calculated to assess intra-and interobserver agreement for each image set, and scores were compared with the histological gold standard using receiver operating characteristic (ROC) analysis to evaluate diagnostic ability. Results: Intraobserver kappa coefficients calculated for each observer for each method of detecting caries ranged from 0.739 to 0.928. Strong interobserver agreement ranging from 0.631 to 0.811 was found for all detection methods. The highest Az values for all three observers were obtained with the cone beam CT images; however, differences between detection methods were not statistically significant (P . 0.05). Conclusion: Visual inspection, film, CCD, PSP plates and cone beam CT performed similarly in the detection of proximal caries.

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of different imaging modalities in detection of proximal caries

Şenel¹,

Kamburoğlu²,

Üçok³

et al. 2010

107

“…16 Many studies show that CBCT caries detection rates are approximately equivalent to intraoral modalities for non-restored teeth. 11,[17][18][19][20][21][22][23] A recent review of the literature summarises that CBCT is equivalent to intraoral techniques at detecting clinically relevant caries lesions in minimally restored teeth; however, beam-hardening and streak artefacts from metal objects and dense tooth structure (enamel) are limiting factors. 24,25 Furthermore, increased dose, cost, time and artefact concerns dictate that bitewing radiographs are still the preferred modality for proximal caries detection.…”

Section: Introductionmentioning

confidence: 99%

Ex vivoevaluation of new 2D and 3D dental radiographic technology for detecting caries

Gaalaas¹,

Tyndall²,

Mol³

et al. 2016

Self Cite

Objectives: Proximal dental caries remains a prevalent disease with only modest detection rates by current diagnostic systems. Many new systems are available without controlled validation of diagnostic efficacy. The objective of this study was to evaluate the diagnostic efficacy of three potentially promising new imaging systems. Methods: This study evaluated the caries detection efficacy of Schick 33 (Sirona Dental, Salzburg, Austria) intraoral digital detector images employing an advanced sharpening filter, Planmeca ProMax ® (Planmeca Inc., Helsinki, Finland) extraoral "panoramic bitewing" images and Sirona Orthophos XG3D (Sirona Dental) CBCT images with advanced artefact reduction. Conventional photostimulable phosphor images served as the control modality. An ex vivo study design using extracted human teeth, ten expert observers and micro-CT ground truth was employed. Results: Receiver operating characteristic analysis indicated similar diagnostic efficacy of all systems (ANOVA p . 0.05). The sensitivity of the Schick 33 images (0.48) was significantly lower than the other modalities (0.53-0.62). The specificity of the Planmeca images (0.86) was significantly lower than Schick 33 (0.96) and XG3D (0.97). The XG3D showed significantly better cavitation detection sensitivity (0.62) than the other modalities (0.48-0.57). Conclusions:The Schick 33 images demonstrated reduced caries sensitivity, whereas the Planmeca panoramic bitewing images demonstrated reduced specificity. XG3D with artefact reduction demonstrated elevated sensitivity and specificity for caries detection, improved depth accuracy and substantially improved cavitation detection. Care must be taken to recognize potential false-positive caries lesions with Planmeca panoramic bitewing images. Use of CBCT for caries detection must be carefully balanced with the presence of metal artefacts, time commitment, financial cost and radiation dose.

“…10 Nevertheless, the radiographic diagnosis of caries lesions depends on the contrast and, therefore, demineralization has to encompass at least 30-40% of the enamel layer to be observed, implying an irreversible mineral loss. 8,11 Cone beam CT (CBCT) was developed to address the demand for three-dimensional (3D) information obtained by CT. [12][13][14][15][16][17][18][19][20] The applicability of CBCT images for detecting approximal caries lesions has already been investigated. 4,9,13,18,19,21,22 However, few studies have focused on the diagnostic performance of CBCT for the detection of subtle subsurface enamel demineralization.…”

Section: Introductionmentioning

confidence: 99%

Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization

Belém¹,

Tabchoury²,

Ferreira-Santos³

et al. 2013

Objectives: The aim of this study was to assess the performance of photostimulable storage phosphor (PSP) radiographs with or without using the sharpen filter and cone beam CT (CBCT) for detecting enamel subsurface demineralization. Methods: Enamel subsurface demineralization was induced on one of the approximal surfaces of 120 sound human teeth. Standardized images of all teeth were acquired after the demineralization phase using the Digora ® Optime (Orion Corp./Soredex, Helsinki, Finland) (PSP) and the i-CAT™ (Imaging Sciences International, Hatfield, PA) (CBCT) systems. Three calibrated observers interpreted the images using a five-point scale (1, demineralization definitely absent; 2, demineralization probably absent; 3, unsure; 4, demineralization probably present; and 5, demineralization definitely present). Diagnoses were validated by cross-sectional microhardness profiling in the test areas of the approximal surfaces. Interobserver agreement was analysed using kappa statistics. Accuracy was estimated by the areas under the receiver operating characteristic curves (A z ), which were compared using the Kruskal-Wallis test (a 5 5%). Results: Interobserver agreement was higher for CBCT (k 5 0.7-0.8), followed by sharpenfiltered (k 5 0.6-0.7) and original (k 5 0.5-0.6) images. CBCT presented the highest accuracy value (A z 5 0.897) compared with the original (A z 5 0.792) and sharpen-filtered (A z 5 0.712) images. However, no statistical differences were observed between the imaging modalities (p 5 0.0794). Conclusions: It can be concluded that PSP radiographs with or without using the sharpen filter and the CBCT images may be useful adjuncts for detecting subtle approximal enamel demineralization. Dentomaxillofacial Radiology (2013Radiology ( ) 42, 20120313. doi: 10.1259 Cite this article as: Belém MDF, Tabchoury CPM, Ferreira-Santos RI, Groppo FC, HaiterNeto F. Performance of a photostimulable storage phosphor digital system with or without the sharpen filter and cone beam CT for detecting approximal enamel subsurface demineralization.