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      Diagnostic Accuracy of Digitized Conventional Radiographs by Camera and Scanner in Detection of Proximal Caries

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          Abstract

          Background and aims

          Digital radiographs have some advantages over conventional ones. Application of digital recep-tors is not routine yet. Therefore, there is a need for digitizing conventional radiographs. The aim of the present study was to compare the diagnostic accuracy of digitized conventional radiographs by scanner and camera in detection of proximal car-ies.

          Materials and methods

          Three hundred and sixteen surfaces of 158 extracted posterior teeth were radiographed. The radiographs were digitized using a digital camera and a scanner. Five observers scored the images for the presence and depth of caries. Histopathologic sections were the gold standard. Kappa agreement coefficient was used for statistical analysis.

          Results

          Kappa agreement coefficients between the camera and the scanner and also between each one with the gold stan-dard in detecting the depth of caries were 0.504, 0.557 and 0.454, respectively. In detection of caries, the indexes were 0.571, 0.553 and 0.527, respectively.

          Conclusion

          Diagnostic accuracy of camera images in caries detection was more than that of scanned images, but there was also a moderate consistency between them. The consistency of detecting the presence of caries was more than that of detecting their depths. It seems that both digital cameras and scanners can be used interchangeably.

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          Most cited references13

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          Radiographic detection of approximal caries: a comparison of dental films and digital imaging systems.

          K Syriopoulos, G C Sanderink, Frits Rhee … (2000)
          To compare the diagnostic accuracy for the detection of approximal caries of two dental X-ray films, two CCD-based digital systems and two storage phosphor (SP) digital systems. Fifty-six surfaces in 56 extracted unrestored premolars were radiographed under standardised conditions using two E-speed dental film, Ektaspeed Plus (Eastman Kodak Co, Rochester, NY, USA) and Dentus M2 Comfort (Agfa-Gevaert, Mortsel, Belgium), two CCD systems, Sidexis (Sirona, Bensheim, Germany) and Visualix (Gendex, Milan, Italy) and two SP systems, Digora (Soredex, Helsinki, Finland) and DenOptix (Gendex, Milano, Italy). The images were assessed by eight observers (four radiologists and four general practitioners). True caries depth was determined by histological examination. True caries depth was subtracted from the values given by the observers and an analysis of variance was performed. The null hypothesis was rejected when P < 0.05. No significant differences were found in diagnostic accuracy with the two dental films and the Sidexis and Digora systems. The depth of the lesion significantly affected observer performance. Caries depth was underestimated. Radiologists performed significantly better than general practitioners whatever the recording system. The diagnostic accuracy of digital systems is comparable with that of dental films. The ability of dentists to recognise caries correctly is the main factor contributing to variation in radiographic diagnosis and not the imaging modality.
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            Detection of proximal caries with high-resolution and standard resolution digital radiographic systems.

            J Verheij, G C Sanderink, K Syriopoulos … (2007)
            The aim of this study was to: (1) compare the diagnostic accuracy of the high-resolution and standard resolution settings of four digital imaging systems for caries diagnosis and (2) compare the effect on the diagnostic accuracy of reducing the high-resolution image sizes to the standard resolution dimensions, and vice versa. 90 extracted human premolars were mounted in groups of 5 in plaster blocks, containing 4 test teeth and 1 non-test tooth. Two blocks at a time were placed in a jig to simulate a bitewing radiograph. Radiographs were taken using four digital systems (Planmeca Dixi 2; Gendex Visualix HDI; Dürr Vistascan; Digora Optime), each at two resolution settings. Next, the teeth were sectioned and a total of 65 surfaces were incorporated in the study. Additionally, the bicubic interpolation method was applied to reduce the high-resolution original images and to enlarge the standard resolution images. The original, reduced and enlarged images were randomly shown to five observers in two random sessions. The observers were asked to assess caries depth on a 4-point scale. The observers' scores were compared with the results from a histological examination. Data were analysed using the statistical theory for multivariate discrete data. Cohen's kappa was used to determine the agreement with the gold standard. None of the comparisons between the spatial resolution settings, or the comparisons between increased or reduced image size and the original image sizes, showed significant differences in the probability of caries detection (chi2=26.59, df=26, P approximately 0.50). The four digital systems used in this study differ significantly in the probability of caries detection (chi2=41.55, df=24, P<0.02). Compared with the gold standard, the Gendex Visualix HDI CCD sensor has the highest measure of agreement (kappa=0.31). Caries diagnosis does not improve when using high-resolution settings compared with the standard settings. The use of bicubic convolution interpolation for zooming has no detectable effect on caries diagnosis and therefore is recommended to use when enlarging or reducing radiographs. The probability of caries detection, however, was different for the sensor systems of the different manufacturers.
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              Linear and logarithmic subtraction for detecting enamel subsurface demineralization.

              C P M Tabchoury, Christina Ferreira, F Bóscolo … (2005)
              To compare the diagnostic performance of linear and logarithmically contrast-enhanced subtraction images, acquired with digital and digitized radiographs, in detecting approximal enamel subsurface demineralization. Fifty caries-free human third molars were immersed in a demineralizing solution for 60, 75, 90, and 120 days, in order to induce artificial enamel subsurface demineralization. The teeth were coated with nail varnish, leaving only a circular window of approximately 7 mm2 in one of the approximal surfaces, allowing contact with the solution. Standardized radiographs of the teeth were taken prior to and after the demineralization period with three digital systems, CygnusRay MPS, DenOptix and DIGORA, and InSight film. Conventional, digital and digitized radiographs were assessed by three experienced radiologists. Linear and logarithmically contrast-enhanced subtraction images were acquired and then examined by a fourth independent radiologist. For the validation of the radiographic diagnosis, the enamel test areas were submitted to Knoop microhardness profiling. Radiographic interpretation data was evaluated using ROC analysis. The areas under the ROC curves (Az) were compared by the chi-squared test. The level of significance was set at P=0.05. No significant differences were found between linear and logarithmically contrast- enhanced subtraction images, acquired with the four studied modalities: CygnusRay MPSlinear (Az=0.95), CygnusRay MPSlog (Az=0.98), DenOptixlinear (Az=0.97), DenOptixlog (Az=0.99), DIGORAlinear (Az=0.98), DIGORAlog (Az=0.98), digitized radiographylinear (Az=0.99), digitized radiographylog (Az=0.99). Linear and logarithmically contrast-enhanced subtraction images, acquired with digital and digitized radiographs, were diagnostically comparable for assessing enamel subsurface demineralization.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Dent Res Dent Clin Dent Prospects
                Journal ID (iso-abbrev): J Dent Res Dent Clin Dent Prospects
                Journal ID (publisher-id): Journal of Dental Research, Dental Clinics, Dental Prospects
                Title: Journal of Dental Research, Dental Clinics, Dental Prospects
                Publisher: Tabriz University of Medical Sciences
                ISSN (Print): 2008-210X
                ISSN (Electronic): 2008-2118
                Publication date (Print): Autumn 2009
                Publication date (Electronic): 15 December 2009
                Volume: 3
                Issue: 4
                Pages: 126-131
                Affiliations
                1 Assistant Professor, Department of Oral and Maxillofacial Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                2 Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                3 Post-graduate student, Department of Pediatrics, Faculty of Dentistry, Azad University of Medical Sciences, Tehran, Iran
                4 Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
                Author notes
                [* ] Corresponding Author; valizadehsf@ 123456yahoo.com
                Article
                DOI: 10.5681/joddd.2009.031
                PMC ID: 3463097
                PubMed ID: 23230500
                SO-VID: 2bd160af-0f02-46bb-9739-bf5418305ac5
                Copyright © © 2009 The Authors; Tabriz University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 License( http://creativecommons.org/licenses/by/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 June 2009
                Date accepted : 24 August 2009
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Dentistry
                Keywords: digital camera,scanner,proximal caries,conventional radiographs
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: digital camera, scanner, proximal caries, conventional radiographs

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