title: In vivo comparison of Visualix-2 and Ektaspeed Plus in the assessment of periradicular lesion dimensions.
abstract: Accurate assessment of intraosseous lesion dimensions is useful in determining strategies for treatment of periradicular pathoses of dental causation.
  
  
  OBJECTIVE
  To compare the efficacy of digital versus analog imaging for the measurement of mesiodistal and vertical dimensions of periapical lesions in patients that require apical surgery.
  
  
  METHODS
  Fourteen examiners assessed the dimensions of 28 lesions with a millimeter ruler and Ektaspeed Plus radiographs (Eastman Kodak, Rochester, N.Y.), and with the Visualix-2 (Gendex/Dentsply, Milan, Italy) in unenhanced, contrast-stretched and equalized modes with proprietary software mouse-driven measurement algorithm. Impregum F (Premier Dental Products) impressions at surgery were used as the "gold standard." Ten randomly chosen images were reread 2 weeks later to assess intra-operator reliability. As the Mauchly sphericity test was significant for all tests, a multivariate analysis of variance was used to assess accuracy. To explain the exact difference between means, the Bonferroni test was applied. Intra-observer reliability was assessed with Friedman's two-way analysis of variance; inter-observer effects were determined with Cronbach's alpha.
  
  
  RESULTS
  For accuracy in measurement, the closest to the "gold standard" were achieved with the Visualix-2 with image equalization. The contrast-stretched Visualix-2 and unenhanced Visualix-2 measurements were less accurate; conventional film was consistently the least accurate (p < 0.002). On the other hand, subjective preference placed film radiographs above the unenhanced Visualix-2 images; contrast-stretched Visualix-2 images were preferred over all other modalities.
  
  
  CONCLUSIONS
  Charge-coupled device-based images with the Visualix-2 are preferable to film-based radiographs for measuring periapical lesion dimensions.
authors.affiliation: School of Dentistry, University of Louisville, Kentucky 40292, USA. agfarm01@ulkyvm.louisville.edu
authors.forename: A G
authors.initials: AG
authors.lastname: Farman
authors.forename: S L
authors.initials: SL
authors.lastname: Avant
authors.forename: W C
authors.initials: WC
authors.lastname: Scarfe
authors.forename: T T
authors.initials: TT
authors.lastname: Farman
authors.forename: D B
authors.initials: DB
authors.lastname: Green
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D000704:Analysis of Variance; D006801:Humans; D015999:Multivariate Analysis; D015588:Observer Variation; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement; D019252:Radiography, Dental, Digital / Q000379:methods*; D015203:Reproducibility of Results; D014962:X-Ray Film