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. 2019 Feb;48(2):20170450.
doi: 10.1259/dmfr.20170450. Epub 2018 Sep 21.

A comparison of diagnosis of early stage interproximal caries with bitewing radiographs and periapical images using consensus reference

Noriaki Takahashi  1 , Cliff Lee  2   3 , John Daren Da Silva  2 , Hiroe Ohyama  2 , Motoi Roppongi  1 , Hidemichi Kihara  1 , Wataru Hatakeyama  2 , Shigemi Ishikawa-Nagai  2 , Mitsuru Izumisawa  1
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A comparison of diagnosis of early stage interproximal caries with bitewing radiographs and periapical images using consensus reference

Noriaki Takahashi et al. Dentomaxillofac Radiol. 2019 Feb.

Abstract

Objectives:: The purpose of this study was to assess the diagnostic property of intraoral bitewing radiographs (BTW) for early stage interproximal caries, and to compare them with periapical radiographs (PA) at different levels of caries progression.

Methods:: A total of 241 interproximal surfaces of BTW and corresponding PAs were used. Seven teaching faculty consisting of three oral and maxillofacial radiologists, two operative faculty, and two prosthodontists evaluated the images. The observers graded images as either "intact", "enamel caries <1/2 width", "enamel caries >1/2 width", or "caries into dentin". The gold-standard was established by consensus of two experienced faculty with 35 years and 27 years of experience. Specificity, sensitivity, positive-predictive value, and negative-predictive value were calculated for the different level of caries progression. Furthermore, receiver operating curves) of BTW and PAs of each evaluator were made and the area under the curve of BTW and PAs were compared.

Results:: There was no significant difference in the specificity of BTW and PAs. BTW showed significantly higher sensitivity than PAs in all levels of caries progression (p<0.01). Positive-predictive value and negative-predictive value of BTWs were also significantly higher than PAs. One-way ANOVA and Tukey HSD test showed a significant difference in sensitivity with different levels of caries progression. The average area under the curve was significantly higher for BTWs than PAs (p<0.01).

Conclusions:: BTWs offer a significant advantage over PAs in the diagnoses of early stages of interproximal carious lesions.

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Figures

Figure 1.
Figure 1.
Sample images of intraoral bitewing and periapical radiographs used for evaluation.
Figure 2. <b>Fig.2</b>
Figure 2. Fig.2
Comparison of mean sensitivity of BTW and PA in different levels of caries progression. BTW, biteweing radiographs; PA, periapical radiographs.
Figure 3.
Figure 3.
ROCs of bitewing and periapical radiographs for seven evaluators. ROCs, receiver operating characteristics.
See this image and copyright information in PMC

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