Radiographic diagnosis of proximal caries is not affected by exposure protocols and presence of high-density material on systems with automatic exposure compensation.

Abstract

To investigate the performance of radiographic systems with automatic exposure compensation (AEC) on the caries diagnosis in images acquired with different exposure parameters and in the presence of high-density material. Also, the image quality was assessed. Forty posterior teeth (80 proximal surfaces) were radiographed using a phosphor plate and a CMOS system. Images were acquired with different exposure times (0.06, 0.10 and 0.16s) and kilovoltages (60 and 70kVp), in the absence and presence of high-density material in the X-rayed region (control and high-density groups). Five radiologists assessed the caries using a 5-point scale. Diagnostic values were compared using two-way ANOVA. For both radiographic systems, there were no significant differences in the area under the ROC curve (0.60-0.73), sensitivity (0.79-0.87) and specificity (0.29-0.48) between the control and high-density groups, exposure times or kilovoltages (p > 0.05). For image quality, scores assigned to the control and high-density groups were similar in each exposure protocol in both systems. The presence of high-density material, exposure time and kilovoltage did not affect the caries diagnosis in any of the systems tested. It is recommended to use protocols with lower doses to reduce the patient's exposure.