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Ruiz DC, Farias-Gomes A, Fontenele RC, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ, Groppo FC. Influence of extensive use of a photostimulable phosphor receptor on the diagnosis of proximal carious lesions: An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:539-547. [PMID: 36566136 DOI: 10.1016/j.oooo.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of the extensive use of a photostimulable phosphor (PSP) receptor on the diagnosis of proximal carious lesions. STUDY DESIGN Forty posterior teeth were paired and mounted in 20 phantoms. Using a PSP receptor of the Express intraoral system, 1 radiograph of each phantom was acquired, totaling 20 radiographs (group 1). After 400 acquisitions, another radiograph of each phantom was obtained, totaling 20 new radiographs (group 2). This procedure was also done after 800 (group 3), 1,200 (group 4), and 1,600 (group 5) acquisitions, resulting in 100 radiographs. Another 40 radiographs (20 phantoms × 2 groups) were obtained with a second PSP sensor to evaluate the diagnostic replicability of the receptors. All 140 radiographs were assessed independently by 5 examiners for the presence of proximal caries. Area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared among the groups by analysis of variance. The Student t test evaluated the diagnostic replicability of the receptors. The significance level was set at 5% (P < .05). RESULTS The diagnostic outcomes for proximal caries did not differ among the groups (P ≥ .37). The diagnostic values did not differ among the radiographs acquired with the 2 PSP receptors (P ≥ .75). CONCLUSIONS The diagnosis of proximal carious lesions was not affected by extensive use of the PSP receptor.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Hugo Gaêta-Araujo
- School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Wenzel A. Radiographic modalities for diagnosis of caries in a historical perspective: from film to machine-intelligence supported systems. Dentomaxillofac Radiol 2021; 50:20210010. [PMID: 33661697 PMCID: PMC8231685 DOI: 10.1259/dmfr.20210010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 01/17/2023] Open
Abstract
Radiographic imaging for the diagnosis of caries lesions has been a supplement to clinical examination for approximately a century. Various methods, and particularly X-ray receptors, have been developed over the years, and computer systems have focused on aiding the dentist in the detection of lesions and in estimating lesion depth. The present historical review has sampled accuracy ex vivo studies and clinical studies on radiographic caries diagnosis that have compared two or more receptors for capturing the image. The epochs of film radiography, xeroradiography, digital intraoral radiography, panoramic radiography and other extraoral methods, TACT analysis, cone-beam CT and artificial intelligence systems aiding in decision-making are reviewed. The author of this review (43 years in academia) has been involved in caries research and contributed to the literature in all the mentioned epochs.
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Affiliation(s)
- Ann Wenzel
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Kamburoğlu K, Sönmez G, Berktaş ZS, Kurt H, Özen D. Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth. Imaging Sci Dent 2017; 47:109-115. [PMID: 28680847 PMCID: PMC5489666 DOI: 10.5624/isd.2017.47.2.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/09/2017] [Accepted: 05/13/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. Materials and Methods Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a 100×90-mm field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of α=.05. Results Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant (P>.05). Conclusion Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Zeynep Serap Berktaş
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hakan Kurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Doĝukan Özen
- Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
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Silverstrim KJ, Schneider E, van der Hoeven C. Image optimization in digital dental radiography. HEALTH PHYSICS 2015; 108:580-591. [PMID: 25905519 DOI: 10.1097/hp.0000000000000273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Presented is a method for establishing the appropriate balance of image quality and radiation dose for dental imaging. Using the Monte Carlo N-Particle Extended (MCNPX) radiation transport code, the DC Planmeca radiographic unit and a dental bitewing phantom were modeled. The Carestream 6100 RVG sensor signal response, noise response, dose rate dependence, and reproducibility were determined experimentally, including uncertainties and inter/intraunit variabilities. The computationally varied parameters were peak kilovoltage and tube filtration. The entrance air kerma for the current clinical technique was used to establish reference image quality. Four figures of merit (FOM) were chosen to encompass parameter variation. With equal weighting of FOMs and no equipment limitations, the optimal parameters were 90 kVp with 0.1 mm added copper filtration. The optimal technique in the radiographic units' operating range was 70 kVp and 0.1 mm added copper filtration, resulting in a ∼50% (±17%) entrance dose and ∼40% effective dose savings.
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Affiliation(s)
- Kelli J Silverstrim
- *University of Texas at Austin, Nuclear Engineering Teaching Lab, Building 159, 10100 Burnet Road, Austin, TX, 78758; †10th Medical Group, United States Air Force Academy
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De Melo DP, Cruz AD, Melo SLS, De Farias JFG, Haiter-Neto F, De Almeida SM. Effect of Different Tube Potential Settings on Caries Detection using PSP Plate and Conventional Film. J Clin Diagn Res 2015; 9:ZC58-61. [PMID: 26023645 PMCID: PMC4437161 DOI: 10.7860/jcdr/2015/12225.5845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/10/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare intraoral Phosphor Stimulable Plate digital system and intraoral film using different tube settings on incipient proximal caries detection. MATERIALS AND METHODS Five blocks, with five teeth each, were radiographically examined using phosphor plates and F-speed films. The images were acquired in 07 different tube potentials from 50-80 kV. The films were digitized. Three oral radiologists scored the images for the presence of caries using a 5-point rating scale. The areas under ROC curve were calculated. The influence of tube kilovoltage was verified by ANOVA and pair wise comparisons performed using Tukey test. RESULTS Mean ROC curve areas varied from 0.446-0.628 for digital images and 0.494-0.559 for conventional images. The tube setting of 70 kV presented the best result both for digital and conventional images. Considering the image type separately, 70 kV scored highest followed by 75 and 65 kV for digital images (p=0.084). For conventional image modality, even though 70 kV presented the best result, it did not differ significantly from 80 kV, not differing from 60 and 55 kV, which did not differ from 75, 65 and 50 kV (p=0.53). CONCLUSION Phosphor plate digital images seem to be more susceptible to tube setting potential variations then digitized film images.
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Affiliation(s)
- Daniela Pita De Melo
- Faculty, Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
| | - Adriana Dibo Cruz
- Faculty, Department of Oral Diagnosis, Friburgo Dental School, Friburgo Federal University, Nova Friburgo, Brazil
| | - Saulo Leonardo Sousa Melo
- Professor, Department of Oral Pathology, Radiology & Medicine, University of Lowa, Lowa City, Iowa, USA
| | | | - Francisco Haiter-Neto
- Faculty, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Solange Maria De Almeida
- Faculty, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Zayet MK, Helaly YR, Eiid SB. Effect of changing the kilovoltage peak on radiographic caries assessment in digital and conventional radiography. Imaging Sci Dent 2014; 44:199-205. [PMID: 25279340 PMCID: PMC4182354 DOI: 10.5624/isd.2014.44.3.199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 02/26/2014] [Accepted: 04/15/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to investigate the effect of changing the kilovoltage peak (kVp) on the radiographic assessment of dental caries. Materials and Methods Seventy-five extracted posterior teeth with proximal caries or apparently sound proximal surfaces were radiographed with conventional E-speed films and a photostimulable phosphor system using 60 kVp and 70 kVp for the caries assessment. The images were evaluated by three oral radiologists and compared with the results of the stereomicroscope analysis. Results No statistically significant difference was found between 60 kVp and 70 kVp for the caries detection, determination of caries extension into dentin, and caries severity in either the conventional or the digital images. Good to very good inter-observer and intra-observer agreements were found for both kilovoltage values on the conventional and digital images. Conclusion Changing the kilovoltage between 60 kVp and 70 kVp had no obvious effect on the detection of proximal caries or determination of its extension or severity.
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Affiliation(s)
- Mohamed Khalifa Zayet
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
| | - Yara Rabee Helaly
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
| | - Salma Belal Eiid
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
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Tarım Ertas E, Küçükyılmaz E, Ertaş H, Savaş S, Yırcalı Atıcı M. A comparative study of different radiographic methods for detecting occlusal caries lesions. Caries Res 2014; 48:566-74. [PMID: 25073755 DOI: 10.1159/000357596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 11/26/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this in vitro study was to compare the diagnostic accuracy of different radiographic imaging modalities in detecting occlusal caries lesions. MATERIALS AND METHODS Under standardized conditions, 125 extracted human permanent molar teeth with sound or occlusal caries lesions were radiographed using a conventional film system (F-speed), a direct digital imaging system (complementary metal oxide semiconductor sensor), an indirect digital imaging system (photostimulable phosphor plate) and a cone beam computed tomography system (CBCT). Two observers scored the resultant images for the presence or absence of caries. Then, the teeth were histologically prepared and a definite diagnosis was determined by stereomicroscopic assessment. The area under the receiver operating characteristic curve (Az), sensitivity, specificity and accuracy of each imaging modality were calculated, as well as the intra- and interexaminer reproducibility. RESULTS For both thresholds, interexaminer agreement were higher for CBCT. For intraexaminer agreement, observers had different scores for both thresholds, but the scores were generally higher for CBCT. Similar Az values were achieved with all imaging methods at a diagnostic D1 threshold. The Az values of the CBCT system were found to be statistically higher than those of the other imaging modalities at a diagnostic D3 threshold (p > 0.05); no significant differences were found among the other imaging modalities. All radiographic methods showed similar sensitivities, specificities and accuracy in detecting D1 threshold. The CBCT system showed higher sensitivity and accuracy in detecting dentine lesions. CONCLUSIONS Within the limitations of this study, CBCT exhibited better performance in detecting deep occlusal caries lesions than the other radiographic systems.
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Affiliation(s)
- Elif Tarım Ertas
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
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de Molon RS, Batitucci RG, Spin-Neto R, Paquier GM, Sakakura CE, Tosoni GM, Scaf G. Comparison of changes in dental and bone radiographic densities in the presence of different soft-tissue simulators using pixel intensity and digital subtraction analyses. Dentomaxillofac Radiol 2013; 42:20130235. [PMID: 24005061 DOI: 10.1259/dmfr.20130235] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To evaluate the influence of soft-tissue simulation materials on dental and bone tissue radiographic densities using pixel intensity (PI) and digital subtraction radiography (DSR) analyses. METHODS 15 dry human mandibles were divided into halves. Each half was radiographed using a charge-coupled device sensor without a soft-tissue simulation material (Wm) and with 5 types of materials: acrylic (Ac), wax (Wx), water (Wt), wood (Wd) and frozen bovine tissue (Bt). Three thicknesses were tested for each material: 10 mm, 15 mm and 20 mm. The material was positioned in front of the mandible and the sensor parallel to the molar region. The radiation beam was perpendicular to the sensor at 30 cm focal spot-to-object distance. The digital images of the bone and dental tissue were captured for PI analyses. The subtracted images were marked with 14 landmark magnifications, and 2 areas of analyses were defined, forming the regions of interest. Shapiro-Wilk and Kruskal-Wallis tests followed by Dunn's post-test were used (p < 0.05). RESULTS DSR showed that both the material type and the thickness tested influenced the gain of density in bone tissue (p < 0.05). PI analyses of the bone region did not show these differences, except for the lower density observed in the image without soft-tissue simulation material. In the dental region, both DSR and PI showed that soft-tissue simulators did not influence the density in these regions. CONCLUSIONS This study showed that the materials evaluated and their thicknesses significantly influenced the density-level gain in alveolar bone. In dental tissues, there was no density-level gain with any soft-tissue material tested.
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Affiliation(s)
- R S de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
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