title: A comparative study on diagnostic accuracy of colour coded digital images, direct digital images and conventional radiographs for periapical lesions - an in vitro study.
abstract: OBJECTIVE
  The identification and radiographic interpretation of periapical bone lesions is important for accurate diagnosis and treatment. The present study was undertaken to study the feasibility and diagnostic accuracy of colour coded digital radiographs in terms of presence and size of lesion and to compare the diagnostic accuracy of colour coded digital images with direct digital images and conventional radiographs for assessing periapical lesions.
  
  
  METHODS
  Sixty human dry cadaver hemimandibles were obtained and periapical lesions were created in first and second premolar teeth at the junction of cancellous and cortical bone using a micromotor handpiece and carbide burs of sizes 2, 4 and 6. After each successive use of round burs, a conventional, RVG and colour coded image was taken for each specimen. All the images were evaluated by three observers. The diagnostic accuracy for each bur and image mode was calculated statistically.
  
  
  RESULTS
  Our results showed good interobserver (kappa > 0.61) agreement for the different radiographic techniques and for the different bur sizes. Conventional Radiography outperformed Digital Radiography in diagnosing periapical lesions made with Size two bur. Both were equally diagnostic for lesions made with larger bur sizes. Colour coding method was least accurate among all the techniques.
  
  
  CONCLUSIONS
  Conventional radiography traditionally forms the backbone in the diagnosis, treatment planning and follow-up of periapical lesions. Direct digital imaging is an efficient technique, in diagnostic sense. Colour coding of digital radiography was feasible but less accurate however, this imaging technique, like any other, needs to be studied continuously with the emphasis on safety of patients and diagnostic quality of images.
authors.affiliation: Senior Lecturer, Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Room No 101, IDS & SUM Hospital , K-8, Kalinga Nagar, Ghatikia, Bhubaneshwar, Odisha, India .
authors.forename: Abhishek Ranjan
authors.initials: AR
authors.lastname: Pati
authors.affiliation: Professor and Head of Department, Department of Oral Medicine and Radiology, Govt Dental College and Research Institute , Fort, City Bangalore, Karnataka, India .
authors.lastname: Mubeen
authors.affiliation: Associate Professor, Department of Oral Medicine and Radiology, Govt Dental College and Research Institute , Fort, City Bangalore, Karnataka, India .
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: K R
authors.affiliation: Professor and Head of Department, Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University , Room No 101, IDS & SUM Hospital, K-8, Kalinga Nagar, Ghatikia, Bhubaneshwar, Odisha, India .
authors.forename: Sanat Kumar
authors.initials: SK
authors.lastname: Bhuyan
authors.affiliation: Senior Lecturer, Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University , Room No 101, IDS & SUM Hospital, K-8, Kalinga Nagar, Ghatikia, Bhubaneshwar, Odisha, India .
authors.forename: Rajat G
authors.initials: RG
authors.lastname: Panigrahi
authors.affiliation: Senior Lecturer, Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Room No 101, IDS & SUM Hospital , K-8, Kalinga Nagar, Ghatikia, Bhubaneshwar, Odisha, India .
authors.forename: Smita R
authors.initials: SR
authors.lastname: Priyadarshini
authors.affiliation: Reader, Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Room No 101, IDS & SUM Hospital , K-8, Kalinga Nagar, Ghatikia, Bhubaneshwar, Odisha, India .
authors.forename: Satyaranjan
authors.initials: S
authors.lastname: Misra
authors.affiliation: Senior Resident, Department of Oral and Maxillofacial surgery, Maulana Azad Institute of Dental Sciences , New Delhi, India .
authors.forename: Chandravir
authors.initials: C
authors.lastname: Singh
keywords: Conventional radiography; Digital radiography; Periapical lesions