Detection Of Proximal Caries Research Articles

The Validity of Proximal Caries Detection Using Magnifying Visual Aids

The purpose of this study was to determine the validity of proximal caries detection supported by a prism loupe and a surgical microscope used by examiners having different professional experience. One hundred and sixty extracted premolars and molars with varying degrees of proximal caries or sound surfaces were embedded in 10 pairs of models with proximal tooth contacts and a simulated gingiva mask. The proximal surfaces were visually evaluated by 14 observers (7 students, 7 dentists) according to a 5-point caries rating scale using a head-worn prism loupe (×4.5), a surgical microscope (×14) and without any magnifying device (control). The validity of observations was expressed as ROC curves calculated for two gold standard thresholds: (a) the presence of caries and (b) macroscopic cavitation. Repeated measures analysis of variance was used to determine the effects of ‘observer group’ and ‘diagnostic modality’. An influence of the observer group could not be demonstrated (p > 0.72), whereas significant differences were revealed between the diagnostic modalities (p < 0.002). ROC areas of caries detection with magnifying aids were smaller compared to the control group. It was concluded that the use of a prism loupe or a surgical microscope does not improve the validity of proximal caries detection if the operators, irrespective of being dental students or clinical instructors, are inexperienced in its utilisation. In general only moderate validity was achieved with visual inspection of proximal sites.

Influence of the number of basis images and projection array on caries detection using tuned aperture computed tomography (TACT)

OBJECTIVES to determine if the number of basis images and spatial distribution of the projection array used for TACT slice generation influence observer performance in caries detection. METHODS In the first experiment, 2, 4, 8 and 12 basis projections of each of 40 teeth were acquired using a CMOS digital radiography sensor. Projections were distributed radially in space using a 20 degree angular disparity. TACT slices were generated from the four subgroups of images, presented to eight observers, and viewed on a high-resolution monitor. Observers scored the presence/absence of caries using a 5-point confidence scale. Gold standard was histological examination of tooth sections. ROC curves measured observer diagnostic performance. ANOVA tested for significant differences between observers and experimental conditions. In the second experiment, the number of basis projections judged to be satisfactory for TACT slice generation was used. Horizontal and vertical linear arrays of projections were compared to the circular projection array. RESULTS There was a statistically significant difference between the numbers of basis projections in the detection of both occlusal (P=0.006) and proximal caries (P=0.005). No significant difference was found between projection arrays in the detection of either occlusal (P=0.065) or proximal (P=0.515) caries. CONCLUSIONS The number of TACT basis projections significantly influences caries detection. Eight or more images should be used. Either linear-vertical, linear-horizontal or circular arrays of basis projections may be used for TACT slice generation in caries detection tasks.

Performance of RVGui sensor and Kodak Ektaspeed Plus film for proximal caries detection

Objective: A high-resolution charge-coupled device was used to compare the diagnostic performances obtained with Trophy’s new RVGui sensor and Kodak Ektaspeed Plus film with respect to caries detection. Study Design: Three acquisition modes of the Trophy RVGui sensor were compared with Kodak Ektaspeed Plus film. Images of the proximal surfaces of 40 extracted posterior teeth were evaluated by 6 observers. The presence or absence of caries was scored by means of a 5-point confidence scale. The actual caries status of each surface was determined through ground-section histology. Responses were evaluated by means of receiver operating characteristic analysis. Areas under receiver operating characteristic curves (AZ) were assessed through analysis of variance. Results: The mean AZ scores were 0.85 for film, 0.84 for the high-resolution caries mode, and 0.82 for both the lowresolution caries mode and the high-resolution periodontal mode. These differences were not statistically significant (P = .70). The differences among observers also were not statistically significant (P = .23). Conclusion: The performance of the RVGui sensor in high- and low-resolution modes for proximal caries detection is comparable to that of Ektaspeed Plus film. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:381-5)

Performance of a flat-panel display system for proximal caries detection

The validity of a digital display system including CRT, or a liquid crystal display system (LCD) rather than an X-ray film system used in caries detection is evaluated. Ninety-five extracted teeth, including maxillary and mandibular premolars and molars, 45 with incipient proximal caries and 50 without caries, were examined. The radiological images of there teeth were digitized. Seven dentists evaluated the three types of images. The results underwent receiver operating characteristics (ROC) analyses, and differences were evaluated by test of statistical significance. We also studied inter-observer differences in subjective evaluation with regard to the image observation systems. After examination, each observer completed a questionnaire on his or her/ impression of using the modalities, and predicted the order of superiority of the modalities. The differences between these predictions and the observers' actual performances by Az (area under ROC curve) values was evaluated. The differences among the displays was not statistically significant (p>0.05). A discrepancy was found between observers' impressions and analytical results. Film, CRT, and LCD displays were not found statistically different for caries diagnosis in this study. The digital display system therefore considered is useful for caries detection.

Influence of X-ray beam angulation in the detection of proximal caries: Interobserver agreement in the CCD system

The aim of this study was to assess the influence of changes in horizontal and vertical X-ray beam angulation on interobserver agreement in the diagnosis of approximal caries using a charge coupled device-based digital dental imaging system (digital system) in comparison with a conventional film-based radiography (film system).

Observer agreement in the detection of proximal caries with direct digital intraoral radiography

Objective. The aim of this study was to compare several values for consistency obtained by charged-coupled-device-based direct digital intraoral radiography with those obtained by conventional film-based radiography to evaluate observer agreement in determining the depth of proximal caries. Study design. A total of 93 proximal surfaces on radiologic images that were obtained by both the conventional film-based bitewing technique and by direct digital intraoral radiography were evaluated by six observers. One of these observers also evaluated the same images six months after the initial evaluation. The kappa value, consistency ratio, agreement ratio, and Kendall's correlation coefficient were calculated for interobserver and intraobserver agreement. Results. The overall kappa values for interobserver agreement were 0.439 and 0.424 in the direct digital system and the film-based radiography, respectively. The depth-related change of the values showed similar patterns in the two modalities for both interobserver and intraobserver agreement. Conclusion. The digital intraoral system resulted in no deterioration in observer agreement, and it presents no problems for clinical use with respect to the reliability of diagnosis.

A comparison of kodak ektaspeed plus film and the siemens sidexis digital imaging system for caries detection using receiver operating characteristic analysis

Objective. To evaluate the accuracy of proximal caries detection comparing enhanced and unenhanced Siemens Sidexis CCD-based digital images with Ektaspeed Plus films utilizing receiver operating characteristic analysis. Study Design. Sixty extracted teeth (24 posterior and 36 anterior) were imaged under identical standardized geometric and exposure conditions. Six observers, using a 5-point confidence scale, rated 120 proximal surfaces for the presence or absence of carious lesions by means of three image modalities: (1) observer enhanced and (2) unenhanced Sidexis displays, and (3) Ektaspeed Plus films. The ground truth was determined by microscopic analysis of ground sections. Receiver operating characteristic curves were generated with calculated areas (A z) analyzed with analysis of variance for effect of reader, reading, and modality. Results. Analysis of variance demonstrated significant differences among readers, readings and modalities (mean square values of 0.012, 0.005, 0.004, F ratios of 13.604, 5.329, 5.100; p = values of 0.001, 0.043, and 0.030, respectively). Post-hoc paired comparisons of modalities using Tukey's statistic demonstrated that only film and enhanced Sidexis images were different from each other ( p = 0.024). A z scores were 0.7650, 0.7499, and 0.8008 respectively, for unenhanced Sidexis, enhanced Sidexis, and Ektaspeed Plus film. Conclusion. Unenhanced digital Sidexis images were equivalent to film for the detection of proximal caries in this in vitro study. Observer enhanced Sidexis images exhibited a statistically significant lower diagnostic accuracy than the unenhanced digital and film images.

Computed dental radiography system versus conventional dental X-ray films for detection of simulated proximal caries

The diagnostic accuracy of intraoral images obtained with a first generation Computed Dental Radiography (CDR) digital dental imaging system is compared with the diagnostic accuracy of conventional dental x-ray film images using a receiver operating characteristics (ROC) analysis. Fifteen dentition phantoms were constructed. Each contained 4 teeth, consisting of premolar and molar teeth with 6 proximal surfaces. Mechanical defects were created randomly on the proximal surfaces and plugged with dentine powder to simulate caries. Fifteen images of each modality were rated by nine dentists in separate sessions according to their confidence in their ability to detect the simulated caries. The images examined were as follows: original CDR images, CDR images magnified 2×, CDR images magnified 4 ×, Ektaspeed Plus dental x-ray film images, and Ultraspeed dental x-ray film images, both unmagnified and magnified 2 ×. A series of ROC curves indicated the limited usefulness of magnification for the CDR system, and consistently similar success in detecting simulated proximal caries for original CDR images and original film images. The magnification of original film images did not always promote greater success than that obtained with the original film images.

Image quality of an intraoral storage phosphor imaging system for normal anatomical structures, proximal caries and decalcified bone changes

The delineation of normal anatomical structures and the detection of minute changes in proximal caries in extracted teeth and in bone treated with a chemical decalcification process were investigated using the intraoral digital imaging system, Digora. Cathode ray tube (CRT)-output images obtained with the Digora system, film-output images prepared through computed radiography, and conventional periapical film (conventional film) images of the various experimental materials were evaluated visually. The accuracy of detection of the enamel-dentin junction of normal teeth was greater with Digora CRT- and film-output images than with conventional film images. However, no marked differences were observed in the diagnostic power in the examination of other materials. The detection of proximal caries was similar for all three image types, regardless of the caries depth. In the decalcified bone specimens, the increases in the area under the receiver operating characteristic curve (Az value) corresponded to the degree of decalcification, and no differences were observed in the detection of bone changes among the CRT-output, film-output, and conventionals film images. These results suggest that the diagnostic value of Digora system, output primarily as CRT images, is comparable to that of film-output images and conventional film images, and that it is potentially applicable to clinical diagnosis.

Some considerations in the evaluation of diagnostic tests in dentistry.

EditorialSome considerations in the evaluation of diagnostic tests in dentistry.A Wenzel and E H VerdonschotA WenzelSearch for more papers by this author and E H VerdonschotSearch for more papers by this authorPublished Online:29 May 2014https://doi.org/10.1259/dmfr.23.4.7835521SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About Next article FiguresReferencesRelatedDetailsCited byCan preoperative imaging help to predict postoperative outcome after wisdom tooth removal? A randomized controlled trial using panoramic radiography versus cone-beam CT15 March 2013 | Clinical Oral Investigations, Vol. 18, No. 1Comparative Efficacy of Spiral Computed Tomography and Orthopantomography in Preoperative Detection of Relation of Inferior Alveolar Neurovascular Bundle to the Impacted Mandibular Third MolarJournal of Oral and Maxillofacial Surgery, Vol. 67, No. 1Detection of proximal caries with high-resolution and standard resolution digital radiographic systemsWER Berkhout, JGC Verheij, K Syriopoulos, G Li, GCH Sanderink and PF van der Stelt28 January 2014 | Dentomaxillofacial Radiology, Vol. 36, No. 4Effect of various digital processing algorithms on the measurement accuracy of endodontic file lengthOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 103, No. 2Dental caries paradigms in diagnosis and diagnostic research25 July 2006 | European Journal of Oral Sciences, Vol. 114, No. 4Lossy JPEG compression: easy to compress, hard to compareA Fidler, B Likar and U Skalerič13 February 2014 | Dentomaxillofacial Radiology, Vol. 35, No. 2Accuracy of computer-automated caries detection in digital radiographs compared with human observers26 May 2002 | European Journal of Oral Sciences, Vol. 110, No. 3Systematic review in diagnostic radiology.D S MacDonald-Jankowski and M F Dozier29 May 2014 | Dentomaxillofacial Radiology, Vol. 30, No. 2Digital Imaging Modalities for Dental Practice.The Bulletin of Tokyo Dental College, Vol. 42, No. 1Standards for intraoral radiographic imaging.A G Farman29 May 2014 | Dentomaxillofacial Radiology, Vol. 29, No. 5Radiographic detection of approximal caries: a comparison of dental films and digital imaging systems.K Syriopoulos, G C Sanderink, X L Velders and P F van der Stelt29 May 2014 | Dentomaxillofacial Radiology, Vol. 29, No. 5The influence of viewing conditions on radiological diagnosis of periapical inflammation8 July 2000 | British Dental Journal, Vol. 189, No. 1DIGITAL IMAGING FOR DENTAL CARIESDental Clinics of North America, Vol. 44, No. 2The effect of developer age on the detection of approximal caries using three dental films.K Syriopoulos, X L Velders, G C Sanderink, F C van Ginkel, J P van Amerongen and P F van der Stelt28 January 2014 | Dentomaxillofacial Radiology, Vol. 28, No. 4Comparison of microscopy and radiography as gold standards in radiographic caries diagnosis.A Wenzel and H Hintze28 January 2014 | Dentomaxillofacial Radiology, Vol. 28, No. 3The choice of gold standard for evaluating tests for caries diagnosis.A Wenzel and H Hintze28 January 2014 | Dentomaxillofacial Radiology, Vol. 28, No. 3Evaluation of a new radiographic technique: outcome following removal of mandibular third molars.A Wenzel, E Aagaard and S Sindet-Pedersen29 May 2014 | Dentomaxillofacial Radiology, Vol. 27, No. 5Evaluation of a new radiographic technique: diagnostic accuracy for mandibular third molars.A Wenzel, E Aagaard and S Sindet-Pedersen29 May 2014 | Dentomaxillofacial Radiology, Vol. 27, No. 5Performance of some diagnostic systems in the prediction of occlusal caries in permanent molars in 6- and 11-year-old childrenJournal of Dentistry, Vol. 26, No. 5-6Digital radiography and caries diagnosis.A Wenzel29 May 2014 | Dentomaxillofacial Radiology, Vol. 27, No. 1Observer agreement in the detection of proximal caries with direct digital intraoral radiographyOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 85, No. 1Exposure parameters in sens-a-ray direct digital radiography and their effects on diagnostic accuracy of carious lesionsOral Radiology, Vol. 13, No. 2Direct digital radiography for the detection of periapical bone lesions: a clinical studyDental Traumatology, Vol. 13, No. 4Occlusal restorative decisions based on visual inspection -calibration and comparison of different methodsCommunity Dentistry and Oral Epidemiology, Vol. 25, No. 2Reliability of ultrasonography and sialography in the diagnosis of sjögren's syndromeOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 83, No. 3Diagnostic tools and measurements-impact on appropriate careCommunity Dentistry and Oral Epidemiology, Vol. 25, No. 1Diagnostic accuracy of direct digital dental radiography for the detection of periapical bone lesionsOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 82, No. 3Current trends in radiographic caries imagingOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 80, No. 5 Volume 23, Issue 4November 1994Pages: 179-237 © 1994 The Authors. 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A clinical comparison of xeroradiography and film radiography for the detection of proximal caries

Xeroradiographs and conventional film radiographs (D- and E-speed) were compared in a clinical study with the use of 1 complete-mouth radiographs for (1) the presence of interproximal caries and (2) the determination of the depth of interproximal caries with the use of 200 tooth surfaces. In addition, an analysis of correct classification rates making a comparison of the same techniques was conducted. The results with the use of ROC analysis indicated that when a comparison was made of xeroradiography and D- and E-speed film, all techniques were equally useful. A broad range of observer ROC area values was found, indicating that diagnostic performance varies greatly with observer. The results of the diagnostic decisions made on carious surfaces versus noncarious surfaces indicated that all techniques tested were similar: 90% correct for noncarious surfaces and 77% correct for carious surfaces.

Effect of quantum noise on the detection of incipient proximal caries

The effect of quantum noise on the radiographic detectability of proximal carious lesions was studied. Bitewing radiographs obtained from patients considered to be free of caries were digitized and stored in a computer using a sampling interval comparable to screen-film systems. Lesions limited in depth to one half the thickness of the enamel were induced by means of computer simulation. Various amounts of randomly generated quantum noise were added to each radiographic image. The results from observer-performance studies show that the lesions can be detected reliably in the presence of substantial amounts of quantum noise, suggesting that comparable diagnostic performance could be obtained with significantly faster imaging systems than those currently used in dentistry.

The use of fiber optics transillumination for the detection of proximal caries: Evaluation in a field situation

Children in the mixed-dentition stage were examined for proximal caries by means of mirror and explorer, fiber optics transillumination (FOTI), and bitewing radiographs. Examinations were performed with portable dental equipment in two public grammar schools. The purpose was to evaluate FOTI as a diagnostic tool for caries diagnosis in a clinical field situation. The greatest percentage increase in proximal lesions detected by FOTI was recorded in the permanent incisors; however, radiographs were not available for diagnostic confirmation. FOTI proved to be an insensitive method for detecting proximal caries in posterior deciduous or permanent teeth above that which was found by an initial mirror-and-explorer examination.

Accuracy of Panoramic Dental X-Ray Imaging in Detection of Proximal Caries with Multiple Morpological Gradient (mMG) Method

Dental caries is tooth decay caused by bacterial infection. This is commonly known as tooth decay. Classification of caries by location consists of; occlusal caries, proximal caries, root caries and caries enamel. Diagnosis of dental caries in general carried out with the help of radiographic images is called Dental X-Ray. Dental X-Ray consists of bitewing, Periapical and Panoramic. Identification of proximal caries using Dental Panoramic X-Ray lowest precision was compared with both other Dental X-Ray. This study aims to perform sharpening and improving the quality of information contained in the image of Panoramic Dental X-Ray to clarify the edges of the objects contained in the image, making it easier to identify and proximal caries severity. The methods and algorithms used are multiple Morphology Gradient (mMG). The results obtained are increased accuracy in identifying proximal caries 47.5%. Based on the severity of it, that level of enamel = 47.37%; dentin rate = 42.1% and the rate of dentin = 1.3%. Accuracy level of accuracy in identifying proximal caries a higher level of email, so that patients with proximal caries early levels can be tackled early handling by the dentist

A new kind of x-ray examination for preventive dentistry

The objective of this study was to compare the diagnostic accuracy of 3 extraoral imaging modalities with an intraoral bitewing radiograph for proximal caries detection.Three modalities of Cranex TOME scanograms, x-ray film and DenOptix photostimulable phosphor plates with and without digital enhancement, were compared with Insight intraoral radiographs for proximal caries detection. Nine observers evaluated images of the proximal surfaces of 45 extracted posterior teeth. The presence or absence of caries was scored using a 5-point confidence scale. The ground truth was determined from histological sections. Responses were evaluated by repeated measures analysis of variance (ANOVA) for areas under receiver operating characteristic (ROC) curves (Az).Repeated measures ANOVA (at α = 0.05) demonstrated significant differences among modalities (P = .041). Paired t tests with Bonferroni correction demonstrated that Insight was superior to only unenhanced digital scanograms (P = .003). Mean Az scores (±SD) were 0.73 (±0.08) for Insight, 0.65 (±0.06) for screen/film scanogram, 0.64 (±0.04) for unenhanced digital scanogram, and 0.66 (±0.07) for enhanced digital scanogram.The performances of film-based and enhanced digital scanograms were not statistically different from Insight film for proximal caries detection. Unenhanced digital scanograms exhibited a statistically significant lower diagnostic accuracy than Insight film.