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A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximal caries detection in posterior teeth

Z Z Akarslan^*,1, M Akdeveliolu¹, K Güngör¹ and H Erten²

¹Department of Oral Diagnosis and Radiology, Gazi University School of Dentistry, Turkey; ²Department of Operative Dentistry and Endodontics, Gazi University School of Dentistry, Turkey

*Correspondence to: Dr Zühre Zafersoy Akarslan, Gazi Üniversitesi Di Hekimlii Fakültesi Oral Diagnoz ve Radyoloji BD, 8 Cadde, 84 Sok, Emek, Ankara, Türkiye; E-mail: dtzuhre{at}yahoo.com

Received 31 August 2007; revised 11 December 2007; accepted 11 December 2007

Objectives: The aim of this study was to investigate the diagnostic accuracy of conventional bitewing, periapical radiographs, unfiltered and filtered digital panoramic images for the assessment of approximal carious lesions in posterior teeth.

Methods: 20 patients who required bitewing, periapical and panoramic radiographs participated in the study. The digital panoramic images were treated with the "sharpen", "smooth" and "emboss" filters. Three experienced observers evaluated the bitewing and periapical radiographs, and the unfiltered and filtered digital panoramic images for the presence or absence of approximal carious lesions according to a 5-point confidence scale. Intra- and interobserver reliability was analysed with the Cronbach alpha test and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis.

Results: According to the results, the intra- and interobserver agreement levels were found to be almost perfect. The highest diagnostic accuracy was found for the bitewing, followed by the periapical and panoramic images. Compared with the unfiltered panoramic images, the filtered images had an almost equal or slightly higher diagnostic accuracy. The largest increase in diagnostic accuracy was observed for those images filtered with the emboss filter.

Conclusions: The accuracy of unfiltered and filtered digital panoramic images is lower than conventional bitewing and periapical radiographs. The filtration of the digital panoramic images, especially the emboss filter, may have some value for the detection of approximal carious lesions.

Keywords: approximal caries, bitewing, periapical, digital panoramic

This article has been cited by other articles:

				Z. Akarslan Author's reply to the Letter to the Editor entitled "Gold standard for the comparison of the diagnostic accuracy of panoramic images for approximal caries detection" published in Dentomaxillofacial Radiology (2009;38:245) Dentomaxillofac. Radiol., October 1, 2009; 38(7): 493 - 493. [Full Text] [PDF]

				A Wenzel Reply to the above commentary on the Letter to the Editor entitled "Gold standard for the comparison of the diagnostic accuracy of panoramic images for approximal caries detection" published in Dentomaxillofacial Radiology (2009;38:245) Dentomaxillofac. Radiol., October 1, 2009; 38(7): 494 - 494. [Full Text] [PDF]

				A Wenzel Gold standard for the comparison of the diagnostic accuracy of panoramic images for approximal caries detection Dentomaxillofac. Radiol., May 1, 2009; 38(4): 245 - 245. [Full Text] [PDF]