STATIONARY INTRAORAL TOMOSYNTHESIS IN PROXIMAL CARIES DETECTION: AN EX-VIVO STUDY

Abstract

<h3>BACKGROUND</h3> Research on radiographic detection of proximal caries has shown high specificity but low sensitivity, especially for early caries lesions. Stationary intraoral tomosynthesis (s-IOT) shows promise in caries detection, utilizing multibeam carbon nanotube source array technology and a direct intraoral detector to acquire images at similar radiation dose to standard bitewings and generating stacks of parasagittal image slices with an iterative reconstruction algorithm. <h3>OBJECTIVE(S)</h3> This study aimed to compare the diagnostic accuracy of s-IOT and conventional digital bitewing modalities for the detection of proximal caries lesions. <h3>STUDY DESIGN</h3> Extracted permanent posterior teeth (n = 64) with proximal surfaces scored between 0 and 4 in the International Caries Detection Assessment System were mounted in phantom heads for imaging. Eight observers, each with 2 or more years of radiology specialty training, scored surfaces on a 5-point Likert scale for caries presence and depth using s-IOT images and digital bitewings, in a standardized viewing format. Fifty percent of specimens will be repeated for intra-examiner reliability assessment. Results will be compared with a histologic gold standard and analyzed by logistic regression and receiver operating curve (Az value). The study is currently in progress, with final results expected by August 2020. <h3>RESULTS</h3> Pilot test results with 3 observers showed s-IOT to have a sensitivity of 49.6% and specificity of 86.1%, with interobserver agreement of 0.433. The conventional bitewing modality had a sensitivity of 47.9% and specificity of 83.3%, with interobserver agreement of 0.380. <h3>DISCUSSION/CONCLUSIONS</h3> Based on preliminary data, the 2 imaging modalities showed small differences between sensitivity, specificity, and interobserver kappa reliability, indicating that s-IOT is comparable to digital bitewings for the detection of proximal caries.