title: Conventional, digital and contrast-enhanced bitewing radiographs in the decision to restore approximal carious lesions.
abstract: The purpose of the present investigation was to compare the accuracy of treatment decisions in proximal sites using three intra-oral radiographic systems. Additionally, the impact of an automated non-linear grey-level display was evaluated. Ten observers assessed 84 surfaces on bitewing radiographs for their requirement of restorative treatment using a 6-rank confidence scale. Radiographs were taken with conventional film images (Ultraspeed), a storage phosphor plate (Digora) and a CCD system (Dexis). Additionally, the Dexis software was expanded by a contrast enhancement routine (Dexis+). The restorative treatment threshold was defined as presence of macroscopic cavitation. Regarding the areas below mean ROC curves no significant differences were detected between the groups (p>0.05). Likelihood ratios for positive test results were: 5.29 (Ultraspeed), 8.14 (Digora), 9.67 (Dexis) and 11.37 (Dexis+). The accuracy of restorative treatment decisions based on digital and conventional radiographs is comparable. If a dichotomous treatment decision was requested, the digital systems demonstrated a notable tendency towards higher likelihood of true-positive decisions.
authors.affiliation: Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Germany. Rainer.Haak@medizin.uni-koeln.de
authors.forename: R
authors.initials: R
authors.lastname: Haak
authors.forename: M J
authors.initials: MJ
authors.lastname: Wicht
authors.forename: M J
authors.initials: MJ
authors.lastname: Noack
mesh_terms: D016001:Confidence Intervals; D003287:Contrast Media; D003661:Decision Support Techniques; D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D006801:Humans; D016013:Likelihood Functions; D015588:Observer Variation; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods; D016300:Radiography, Bitewing / Q000379:methods*; D019252:Radiography, Dental, Digital; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media