Evaluation of Diagnostic Efficacy of Improved Interproximal Program and Bitewing Program in Proximal Caries Detection- An Extraoral Radiographic Comparative Study

Abstract

Background: To look for an alternative to intraoral bitewing radiographs when the intraoral placement of film is not feasible or multiple teeth have to be screened. Objectives: A study to evaluate and compare the efficacy of improved interproximal and bitewing programs for detection of proximal caries Planmeca ProMax was conducted. Materials and Methods: Fifty patients who were screened for proximal caries and confirmed with intraoral bitewing radiography were subjected to improved interproximal program and bitewing program in Planmeca ProMax (Planmeca Oy, Helsinki, Finland) after obtaining informed consent. These radiographs were evaluated by three observers. Intra- and interclass correlation was done to check reliability of the observers, and ROC analysis was done to evaluate the diagnostic accuracy. Critical ratio analysis was done to know the significance. Results: Both improved interproximal program and bitewing programs have similar diagnostic efficacy. ROC curve area of improved interproximal program was 0.833 while bitewing program showed 0.878. Bitewing program showed specificity value of 76% compared to 67% in improved interproximal program while both were equally sensitive. Conclusion: Both bitewing program and improved interproximal program are highly sensitive in detecting proximal caries when compared to intraoral bitewing radiography which is still considered the gold standard in diagnosis of an interproximal caries.