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Dentomaxillofacial Radiology (2009) 38, 452-457
© 2009 British Institute of Radiology
doi: 10.1259/dmfr/34393803

RESEARCH

Comparison of visual inspection and different radiographic methods for dentin caries detection on occlusal surfaces

J Kühnisch*,1, S Ifland2, S Tranæus and R Heinrich-Weltzien2

1Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-University of Munich, Germany; 2Department of Preventive Dentistry, Friedrich-Schiller-University of Jena, Germany; 3Institute of Odontology, Karolinska Institutet, Huddinge, Sweden; 4The Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden

*Correspondence to: Jan Kühnisch, Ludwig-Maximilians-Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336 München, Germany; E-mail: jkuehn{at}dent.med.uni-muenchen.de

Received 4 June 2008; revised 8 August 2008; accepted 13 August 2008

Objectives: The aim of the present study was to assess the validity of the digital phosphor plate radiographic technique (Gendex Dental Systems) on occlusal surfaces in comparison with visual examination and conventional E- and F-speed films.

Methods: The study material consisted of 54 non-cavitated third molars with a range of appearances, including apparently sound surfaces. Each surface was visually examined (VI) according to the criteria established by Ekstrand et al. Three radiographic images (E-speed, F-speed, digital phosphor plate film) were taken of each molar. The standardized radiograph technique used an alignment fixture to reproduce the focus-to-object distance as well as the object-to-film distance. Afterwards each tooth was cut into sections in the buccolingual direction with a microtome saw, and caries extension was assessed using light microscopy (LM) and microradiography (MR). The statistical analysis included the calculation of sensitivity (SE), specificity (SP) and Az values.

Results: The following validity parameters were found for the tested diagnostic methods on the dentin caries level: VI/LM, 68.0 SE/93.1 SP/0.698 Az; VI/MR, 68.2/87.5/0.751; E-speed/LM, 76.0/78.6/0.637; E-speed/MR, 77.3/74.2/0.681; F-speed/LM, 64.0/67.9/0.507; F-speed/MR, 68.2/67.7/0.594; Gendex/LM, 60.0/85.7/0.629; and Gendex/MR, 59.1/80.6/0.586.

Conclusion: The methods used showed different levels of validity: E- and F-speed films were linked to higher sensitivity values, whereas a higher specificity was recorded for the tested imaging plate system. In accordance with the diagnostic performance, the digital system can be recommended for practical use and potentially help prevent overtreatment thanks to its high SP.

Keywords: occlusal caries; caries detection; caries diagnosis; digital radiography






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