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RESEARCH |
1 Department of Prosthodontics, Department of Conservative Dentistry, Clinic of Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Germany, 2 Section of Periodontology, Department of Conservative Dentistry, Clinic of Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Germany, 3 Private Practice, Heidelberg, Germany, 4 Department of Periodontology, Center for Dental, Oral, and Maxillofacial Medicine, Hospital of the Johann Wolfgang Goethe-University Frankfurt, Germany
*Correspondence to: Prof. Dr Peter Eickholz, Poliklinik für Parodontologie, ZZMK (Carolinum), Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany; E-mail: eickholz{at}med.uni-frankfurt.de
Received 2 April 2007; revised 22 July 2007; accepted 23 July 2007
Objectives: Evaluation of a particular digital caries image-enhancing mode (filter) for its effect on the validity of measurements of caries lesion depth.
Methods: Standardized radiographs of 44 extracted teeth exhibiting interproximal caries lesions were obtained. Six radiographs were obtained of each tooth and digitized. Four radiographs were made using D-speed film with and without soft tissue scattering equivalent (STSE) at normal exposure time (0.32 s) and underexposed (0.16 s). Two were made using E-speed film with STSE normally (0.16 s) and underexposed (0.08 s). On each of the 264 radiographs, 4 independent examiners measured the central depth (CD) of 1 carious lesion per tooth both on the unchanged radiographic image and after use of the filter. Histometric CD assessments provided a gold standard for comparison with the radiographic measurements (validity). Repeated measures ANOVA was calculated for validity in relation to examiner, lesion type, filter, film type, exposure time and STSE.
Results: The lesion type was identified to statistically significantly influence the validity of CD measurements. Examiner in combination with defect type (P<0.001), filter (P = 0.017), exposure (P = 0.027) and film type (P = 0.044) had an additional albeit small effect.
Conclusions: The lesion type significantly influenced the validity of CD measurements: enamel lesions were less underestimated than dentin lesions.
Keywords: dental caries; radiology, diagnostic X-ray; radiographic image enhancement; validity
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