Accuracy of direct digital radiography for detecting occlusal caries in primary teeth compared with conventional radiography and visual inspection: an in vitro study.
OBJECTIVE
the diagnosis of caries lesions is still a matter of concern in dentistry. The diagnosis of dental caries by digital radiography has a number of advantages over conventional radiography; however, this method has not been explored fully in the field of paediatric dentistry. This in vitro research evaluated the accuracy of direct digital radiography compared with visual inspection and conventional radiography in the diagnosis of occlusal caries lesions in primary molars.


METHODS
50 molars were selected and evaluated under standardized conditions by 2 previously calibrated examiners according to 3 diagnostic methods (visual inspection, conventional radiography and direct digital radiography). Direct digital radiographs were obtained with the Dixi3 system (Planmeca, Helsinki, Finland) and the conventional radiographs with InSight film (Kodak Eastman Co., Rochester, NY). The images were scored and a reference standard was obtained histologically. The interexaminer reliability was calculated using Cohen's kappa test and the specificity, sensitivity and accuracy of the methods were calculated.


RESULTS
examiner reliability was good. For lesions limited to the enamel, visual inspection showed significantly higher sensitivity and accuracy than both radiographic methods, but no significant difference was found in specificity. For teeth with dentinal caries, no significant differences were found for any parameter when comparing visual and radiographic evaluation.


CONCLUSIONS
although less accurate than the visual method for detecting caries lesions confined to the enamel, the direct digital radiographic method is as effective as conventional radiographic examination and visual inspection of primary teeth with occlusal caries when the dentine is involved.
Dias da Silva
P R
PR
Department of Dentistry, University of São Paulo, São Paulo, Brazil. cesaralascala@usp.br
Martins Marques
M
M
Steagall
W
W
Medeiros Mendes
F
F
Lascala
C A
CA
D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000473:pathology; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D019252:Radiography, Dental, Digital / Q000295:instrumentation; D012680:Sensitivity and Specificity; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging* / Q000473:pathology; D014963:X-Ray Intensifying Screens