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. 2013 Apr;7(2):159-164.
doi: 10.4103/1305-7456.110157.

Reliability analysis of two methods for measuring active enamel demineralization: An in vitro study

Camila Nassur  1 , Luciana Pomarico  2 , Lucianne Cople Maia  1
Affiliations

Reliability analysis of two methods for measuring active enamel demineralization: An in vitro study

Camila Nassur et al. Eur J Dent. 2013 Apr.

Abstract

Objective: The aim was to evaluate the intra- and inter-examiner reliability of two methods, namely, digital caliper [DC] and computerized image analysis software (Image Tool [IT] version 4.1) for measuring the area of an active enamel demineralization lesion. The effect on that measurement of a window that delimits the lesion was also assessed.

Materials and methods: Thirty-eight circular artificial enamel demineralization lesions (r = 2 mm) were produced on bovine teeth in vitro, which were then measured three times by three examiners, with and without the presence of a window delimiting the area to be measured. The data were analyzed by the intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and by the Altman and Bland analysis.

Results: The intra-examiner correlation using the IT method showed excellent reproducibility (mean ICC values 0.922-0.970 with the delimiting window and 0.915-0.990 without the window). However, the intra-examiner correlation using the DC method showed comparatively less reproducibility in the measurements (mean ICC values 0.458-0.648 with the delimiting window and 0.378-0.665 without the window). The inter-examiner correlations showed very good reproducibility of the measurements regardless of the presence or absence of the window for both the DC method (0.811-0.846) and IT method (0.953-0.994). However, the latter method showed less variability within the measurements.

Conclusion: However, statistically no significant difference was found between both methodologies. Nevertheless, computerized image analysis with the Image Tool software demonstrated higher intra- and inter-examiner reliability than the digital caliper method, in estimating the area of the enamel demineralization lesion, regardless of the delimiting window.

Keywords: Computerized image analysis; dental caries; image processing; observer variation; reproducibility of results; tooth demineralization.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Photographic apparatus used for standardization of distance and angulation
Figure 2
Figure 2
Dental fragments with (a) and without (b) window. Note the millimeter rule used as a metric parameter for further measurements
Figure 3
Figure 3
Comparison between digital caliper (a) and image tool software (b), with presence (1) and absence (2) of a window established according to Altman and Bland analysis
See this image and copyright information in PMC

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References

    1. Featherstone JD. The continuum of dental caries-evidence for a dynamic disease process. J Dent Res. 2004;83(special No C):C39–42. - PubMed
    1. Featherstone JD. Prevention and reversal of dental caries: role of low level fluoride. Community Dent Oral Epidemiol. 1999;27:31–40. - PubMed
    1. Arends J, Christoffersen J. The nature of early caries lesions in enamel. J Dent Res. 1986;65:2–11. - PubMed
    1. Featherstone JD. Caries detection and prevention with laser energy. Dent Clin North Am. 2000;44:955–69. - PubMed
    1. Pereira AC, Verdonschot EH, Huysmans MC. Caries detection methods: Can they aid decision making for invasive sealant treatment? Caries Res. 2001;35:83–9. - PubMed