Comparative performance of digital and conventional images for detecting proximal surface caries

Abstract

Objective: To evaluate the performance of a digital CCD system for detecting proximal surface caries compared with film.

Method: Three hundred and twenty extracted human teeth were imaged by making direct digital (Schick Technologies, Inc) and conventional film images (E-speed) of each. A total of 16 experienced dentists scored the proximal surfaces of these teeth for the extent of enamel and dentin lesions. The teeth were subsequently sectioned to determine the actual caries depth.

Results: The sensitivity of the CCD system was consistently lower than film while the specificity of the CCD system was consistently higher. The accuracy of CCD and film images was not significantly different, neither when sensitivity and specificity were averaged nor when accuracy was weighted to reflect caries prevalence of 2, 5 or 10%. The predictive values of both positive/negative outcomes were virtually identical for the CCD and film images. The interrater variability in lesion confidence scores with digital images was comparative with film.

Conclusions: Dentists using a direct digital CCD system performed as well in interpreting proximal surface caries as with E-speed film. This work suggests that for this task these two competing systems are diagnostically comparable.