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Freire RT, Prata-Júnior AR, Pinho JNA, Takeshita WM. Diagnostic Accuracy of Caries and Periapical Lesions on a Monitor with and without DICOM-GSDF Calibration Under Different Ambient Light Conditions. J Digit Imaging 2022; 35:654-9. [PMID: 35166971 DOI: 10.1007/s10278-022-00596-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
To evaluate the diagnostic accuracy of caries and periapical lesions on a monitor with and without DICOM part 14: grayscale standard display function (DICOM-GSDF) calibration under different ambient light conditions. Forty digital bitewing radiographs were selected, with or without radiographic images of carious lesions and forty digital periapical radiographs with or without periapical lesions were selected from archives of the Radiology Department at the University Hospital of the Federal University of Sergipe. The gold standard radiographic images were determined through consensus between two radiologists with more than 15 and 30 years of experience. The selected radiographs were evaluated on a LG LED monitor with and without DICOM-GSDF calibration under different ambient light conditions: Lx1 (low ambient lighting), Lx2 (moderate ambient lighting) and Lx3 (high ambient lighting). Kappa (Kw) values determined that evaluator 1 showed almost perfect agreement for all devices, while evaluator 2 presented a substantial agreement for all devices. Monitors with and without DICOM-GSDF calibration have similar accuracy values. The three ambient light conditions analyzed have similar accuracy and can be used for caries lesions diagnosis (p > 0.05); however, the best diagnostic accuracy of periapical lesions was found in Lx 2. The displays with and without DICOM-GSDF calibration studied in this research have similar accuracy and can be used to evaluate digital radiographs without changing the diagnostic capacity. The different ambient lighting conditions did not influence the evaluation of caries lesions. The best diagnostic accuracy of periapical lesions was found in moderate ambient lighting.
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Siqueira AP, Pacheco de Oliveira Mota V, de-Azevedo-Vaz SL. Influence of radiographic acquisition methods and visualization software programs on the detection of misfits at the implant-abutment interface: An ex vivo study. J Prosthet Dent 2021:S0022-3913(21)00589-8. [PMID: 34839908 DOI: 10.1016/j.prosdent.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Misfits at the implant-prosthesis interface may compromise implant-supported prostheses. Periapical radiographs are frequently used to detect misfit and can be obtained by using digital or film-based systems; however, which radiographic acquisition method and visualization software program provides the greatest accuracy is unclear. PURPOSE The purpose of this ex vivo study was to evaluate the influence of 3 radiographic acquisition methods (complementary metal oxide semiconductor [CMOS] sensor, phosphor plates, and radiographic films) and 2 visualization software programs (proprietary and third-party) on the detection of misfits at the implant-prosthesis interface. MATERIAL AND METHODS Thirty-two dental implants were placed in dry human mandibles. Misfits were simulated by inserting a 50-μm polyester strip at the implant-prosthesis interface; prosthetic crowns installed directly over the implant platforms were considered as controls. Standard parallel periapical radiographs were obtained by using a CMOS sensor, a phosphor plate, and radiographic films. Five dentists assessed the digital radiographs for the presence or absence of misfits at the implant-prosthesis interface by using the proprietary software program and a third-party software program; film-based radiographs were evaluated on a light box. The area under the receiver operating characteristic curves (Az values) were compared (α=.05); sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were also estimated. RESULTS All diagnostic and Az values were higher for the phosphor plate than for the CMOS sensor and the film-based methods (P<.05), regardless of the viewing software program used (proprietary or third-party) (P>.05). CONCLUSIONS The use of phosphor plates positively influenced the diagnostic accuracy for the detection of misfits at the implant-prosthesis interface, irrespective of the viewing software program used.
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Hoff RT, Mazulis A, Doniparthi M, Munis A, Rivelli A, Lakha A, Ehrenpreis E. Use of ambient lighting during colonoscopy and its effect on adenoma detection rate and eye fatigue: results of a pilot study. Endosc Int Open 2021; 9:E836-E842. [PMID: 34079864 PMCID: PMC8159586 DOI: 10.1055/a-1386-3879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background and study aims Adenoma detection rate (ADR) appears to decrease as the number of consecutive hours performing procedures increases, and eye strain may be a contributing factor. Ambient light may improve symptoms of eye strain, but its effects have yet to be explored in the field of gastroenterology. We aim to determine if using ambient lighting during screening colonoscopy will maintain ADRs and improve eye strain symptoms compared with low lighting. Methods At a single center, retrospective data were collected on colonoscopies performed under low lighting and compared to prospective data collected on colonoscopies with ambient lighting. Eye fatigue surveys were completed by gastroenterologists. Satisfaction surveys were completed by physicians and staff. Results Of 498 low light and 611 ambient light cases, 172 and 220 adenomas were detected, respectively ( P = 0.611). Under low lighting, the ADR decreased 5.6 % from first to last case of the day ( P = 0.2658). With ambient lighting, the ADR increased by 2.80 % ( P = 0.5445). The difference in the overall change in ADR between first and last cases with ambient light versus low light was statistically significant (8.40 % total unit change, P = 0.01). The average eye strain scores were 8.12 with low light, and 5.63 with ambient light ( P = 0.3341). Conclusions Performing screening colonoscopies with ambient light may improve the differential change in ADR that occurs from the beginning to the end of the day. This improvement in ADR may be related to improvement in operator fatigue. The effect of ambient light on eye strain is unclear. Further investigation is warranted on the impact of ambient light on symptoms of eye strain and ADR.
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Affiliation(s)
- Ryan T. Hoff
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States
| | - Andrew Mazulis
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States
| | - Meghana Doniparthi
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States
| | - Assad Munis
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States
| | - Anne Rivelli
- Advocate Lutheran General Hospital – Russell Research Institute, Park Ridge, Illinois, United States
| | - Asif Lakha
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States
| | - Eli Ehrenpreis
- Advocate Lutheran General Hospital – Medicine, Park Ridge, Illinois, United States,Rosalind Franklin University of Medicine and Science Chicago Medical School – Medicine, North Chicago, Illinois, United States
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Walsh T, Macey R, Riley P, Glenny AM, Schwendicke F, Worthington HV, Clarkson JE, Ricketts D, Su TL, Sengupta A. Imaging modalities to inform the detection and diagnosis of early caries. Cochrane Database Syst Rev 2021; 3:CD014545. [PMID: 33720395 PMCID: PMC8441255 DOI: 10.1002/14651858.cd014545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The detection and diagnosis of caries at the earliest opportunity is fundamental to the preservation of tooth tissue and maintenance of oral health. Radiographs have traditionally been used to supplement the conventional visual-tactile clinical examination. Accurate, timely detection and diagnosis of early signs of disease could afford patients the opportunity of less invasive treatment with less destruction of tooth tissue, reduce the need for treatment with aerosol-generating procedures, and potentially result in a reduced cost of care to the patient and to healthcare services. OBJECTIVES To determine the diagnostic accuracy of different dental imaging methods to inform the detection and diagnosis of non-cavitated enamel only coronal dental caries. SEARCH METHODS Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 31 December 2018); Embase Ovid (1980 to 31 December 2018); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 31 December 2018); and the World Health Organization International Clinical Trials Registry Platform (to 31 December 2018). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included diagnostic accuracy study designs that compared a dental imaging method with a reference standard (histology, excavation, enhanced visual examination), studies that evaluated the diagnostic accuracy of single index tests, and studies that directly compared two or more index tests. Studies reporting at both the patient or tooth surface level were included. In vitro and in vivo studies were eligible for inclusion. Studies that explicitly recruited participants with more advanced lesions that were obviously into dentine or frankly cavitated were excluded. We also excluded studies that artificially created carious lesions and those that used an index test during the excavation of dental caries to ascertain the optimum depth of excavation. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently and in duplicate using a standardised data extraction form and quality assessment based on QUADAS-2 specific to the clinical context. Estimates of diagnostic accuracy were determined using the bivariate hierarchical method to produce summary points of sensitivity and specificity with 95% confidence regions. Comparative accuracy of different radiograph methods was conducted based on indirect and direct comparisons between methods. Potential sources of heterogeneity were pre-specified and explored visually and more formally through meta-regression. MAIN RESULTS We included 104 datasets from 77 studies reporting a total of 15,518 tooth sites or surfaces. The most frequently reported imaging methods were analogue radiographs (55 datasets from 51 studies) and digital radiographs (42 datasets from 40 studies) followed by cone beam computed tomography (CBCT) (7 datasets from 7 studies). Only 17 studies were of an in vivo study design, carried out in a clinical setting. No studies were considered to be at low risk of bias across all four domains but 16 studies were judged to have low concern for applicability across all domains. The patient selection domain had the largest number of studies judged to be at high risk of bias (43 studies); the index test, reference standard, and flow and timing domains were judged to be at high risk of bias in 30, 12, and 7 studies respectively. Studies were synthesised using a hierarchical bivariate method for meta-analysis. There was substantial variability in the results of the individual studies, with sensitivities that ranged from 0 to 0.96 and specificities from 0 to 1.00. For all imaging methods the estimated summary sensitivity and specificity point was 0.47 (95% confidence interval (CI) 0.40 to 0.53) and 0.88 (95% CI 0.84 to 0.92), respectively. In a cohort of 1000 tooth surfaces with a prevalence of enamel caries of 63%, this would result in 337 tooth surfaces being classified as disease free when enamel caries was truly present (false negatives), and 43 tooth surfaces being classified as diseased in the absence of enamel caries (false positives). Meta-regression indicated that measures of accuracy differed according to the imaging method (Chi2(4) = 32.44, P < 0.001), with the highest sensitivity observed for CBCT, and the highest specificity observed for analogue radiographs. None of the specified potential sources of heterogeneity were able to explain the variability in results. No studies included restored teeth in their sample or reported the inclusion of sealants. We rated the certainty of the evidence as low for sensitivity and specificity and downgraded two levels in total for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the in vitro studies, and the observed inconsistency of the results. AUTHORS' CONCLUSIONS The design and conduct of studies to determine the diagnostic accuracy of methods to detect and diagnose caries in situ are particularly challenging. Low-certainty evidence suggests that imaging for the detection or diagnosis of early caries may have poor sensitivity but acceptable specificity, resulting in a relatively high number of false-negative results with the potential for early disease to progress. If left untreated, the opportunity to provide professional or self-care practices to arrest or reverse early caries lesions will be missed. The specificity of lesion detection is however relatively high, and one could argue that initiation of non-invasive management (such as the use of topical fluoride), is probably of low risk. CBCT showed superior sensitivity to analogue or digital radiographs but has very limited applicability to the general dental practitioner. However, given the high-radiation dose, and potential for caries-like artefacts from existing restorations, its use cannot be justified in routine caries detection. Nonetheless, if early incidental carious lesions are detected in CBCT scans taken for other purposes, these should be reported. CBCT has the potential to be used as a reference standard in diagnostic studies of this type. Despite the robust methodology applied in this comprehensive review, the results should be interpreted with some caution due to shortcomings in the design and execution of many of the included studies. Future research should evaluate the comparative accuracy of different methods, be undertaken in a clinical setting, and focus on minimising bias arising from the use of imperfect reference standards in clinical studies.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Heatlh Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
| | | | - Ting-Li Su
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anita Sengupta
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Hastie T, Venske-Parker S, Aps JKM. Impact of viewing conditions on the performance assessment of different computer monitors used for dental diagnostics. Imaging Sci Dent 2021; 51:137-148. [PMID: 34235059 PMCID: PMC8219454 DOI: 10.5624/isd.20200182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/06/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to assess the computer monitors used for analysis and interpretation of digital radiographs within the clinics of the Oral Health Centre of Western Australia. Materials and Methods In total, 135 computer monitors (3 brands, 6 models) were assessed by analysing the same radiographic image of a combined 13-step aluminium step wedge and the Artinis CDDent 1.0® (Artinis Medical Systems B.V.®, Elst, the Netherlands) test object. The number of steps and cylindrical objects observed on each monitor was recorded along with the monitor's make, model, position relative to the researcher's eye level, and proximity to the nearest window. The number of window panels blocked by blinds, the outside weather conditions, and the number of ceiling lights over the surgical suite/cubicle were also recorded. MedCalc® version 19.2.1 (MedCalc Software Ltd®, Ostend, Belgium, https://www.medcalc.org; 2020) was used for statistical analyses (Kruskal-Wallis test and stepwise regression analysis). The level of significance was set at P<0.05. Results Stepwise regression analysis showed that only the monitor brand and proximity of the monitor to a window had a significant impact on the monitor's performance (P<0.05). The Kruskal-Wallis test showed significant differences (P<0.05) in monitor performance for all variables investigated, except for the weather and the clinic in which the monitors were placed. Conclusion The vast performance variation present between computer monitors implies the need for a review of monitor selection, calibration, and viewing conditions.
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Affiliation(s)
- Thomas Hastie
- University of Western Australia, Dental School and Oral Health Centre of Western Australia, Nedlands, Australia
| | - Sascha Venske-Parker
- University of Western Australia, Dental School and Oral Health Centre of Western Australia, Nedlands, Australia
| | - Johan K M Aps
- School of Oral Hygiene, Artevelde University of Applied Sciences, Gent, Belgium
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Lima CAS, Nascimento EHL, Gaêta-Araujo H, Oliveira-Santos C, Freitas DQ, Haiter-Neto F, Oliveira ML. Is the digital radiographic detection of approximal caries lesions influenced by viewing conditions? Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:165-170. [PMID: 31474575 DOI: 10.1016/j.oooo.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/04/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to assess the influence of different viewing conditions (combinations of computer display, horizontal viewing angle, and ambient lighting) on the detection of approximal caries lesions on digital radiographic images. STUDY DESIGN Forty posterior teeth were mounted in a plaster block and radiographed by using a CMOS sensor-based system. Three oral radiologists assessed the radiographic images under different conditions of computer display (iMac 5K 27", Barco MDRC-2124, and Dell P2314H), horizontal viewing angles (90 degrees, 67.5 degrees, and 45 degrees), and ambient lighting (low, medium, and high) and were asked to detect the presence of approximal caries lesions, which were confirmed by means of micro-computed tomography (micro-CT), using a 5-point scale. The area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared by analysis of variance testing (α = 0.05). Intra- and interobserver agreements were assessed with the Kappa test. RESULTS Computer display, horizontal viewing angle, and ambient lighting did not significantly influence the diagnosis of approximal caries lesions. In general, moderate values of accuracy, low sensitivity, and high specificity were found for all viewing conditions. CONCLUSIONS The viewing conditions assessed in this study did not influence the detection of approximal caries lesions on digital radiographic images. Dental practitioners are encouraged to find their most comfortable viewing condition for this diagnostic task.
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Affiliation(s)
- Carlos Augusto Souza Lima
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
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Lima CAS, Freitas DQ, Ambrosano GMB, Haiter-Neto F, Oliveira ML. Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:444-450. [PMID: 30738753 DOI: 10.1016/j.oooo.2019.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/24/2018] [Accepted: 01/01/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate interpretation conditions in the subjective in vitro assessment of dental tissue-equivalent radiographic contrast. STUDY DESIGN Radiographic images with the density of dental structures were randomized and arranged in 20 sequences with images juxtaposed and separated. Twelve observers interpreted the sequence among the most radiolucent and radiopaque images with 3 displays, 3 horizontal viewing angles, and 3 ambient light conditions. The evaluation time was recorded. The hit percentage was calculated for each evaluation. Three-way analysis of variance with Tukey's test was used to compare the conditions of interpretation. The intraclass correlation coefficient was used to assess agreement (α = 0.05). RESULTS No differences in hit percentages were found among the 3 displays or among the juxtaposed and separated images. Increased hit percentages were recorded for images assessed at 90° compared with 45° for all displays and in high ambient light vs intermediate and low light at 90°. Increased evaluation time was recorded for the consumer-grade display under high ambient light and for the separated images. CONCLUSIONS The subjective in vitro assessment of dental tissue-equivalent radiographic contrast is not influenced by computer display, which should be viewed at a horizontal viewing angle of 90° and under high ambient light. Longer evaluation times may be expected with consumer-grade displays.
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Affiliation(s)
- Carlos Augusto Souza Lima
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
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Pakbaznejad Esmaeili E, Pakkala T, Haukka J, Siukosaari P. Low reproducibility between oral radiologists and general dentists with regards to radiographic diagnosis of caries. Acta Odontol Scand 2018; 76:346-350. [PMID: 29648497 DOI: 10.1080/00016357.2018.1460490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM Early clinical and radiological diagnosis of dental caries is one of the fundamental objectives of clinical dentistry because of the high frequency of the disease and severe complications if caries remains untreated, especially among the elderly and patients with immunodeficiency. Dental panoramic tomography (DPT) is a common radiographic method for evaluating dentition when indicated, especially in an adult population. The aim of this study was to assess the reproducibility of diagnosis between specialists in oral radiology and general dentists with regards to caries lesions based on DPTs of adults. MATERIAL AND METHODS One-hundred DPTs taken from adult patients (average age 35) and then analyzed and reported on by 42 general dentists were then analyzed independently by two specialists in oral radiology with respect to caries lesions in the premolar and molar areas using radiographic criteria established for caries diagnosis. The general dentists versus oral radiologists were not calibrated before. Level of agreement between specialists and general dentists was measured using Cohen's kappa. RESULTS Comparison between observations of general dentists and specialists in oral radiology showed that 61% of the caries lesions on proximal surfaces of premolars and molars observed by specialists went unobserved by general dentists. Cohen's kappa value for specialists was 0.85 (p < .001) and for each specialist and general dentists 0.48 (p < .001) and 0.44 (p < .001). CONCLUSIONS The reproducibility between specialists in oral radiology and general dentists for detecting caries in DPTs was low.
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Affiliation(s)
| | - Tuomas Pakkala
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland
| | - Jari Haukka
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Päivi Siukosaari
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
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Nascimento EH, Gaêta-Araujo H, Vasconcelos KF, Freire BB, Oliveira-Santos C, Haiter-Neto F, Freitas DQ. Influence of brightness and contrast adjustments on the diagnosis of proximal caries lesions. Dentomaxillofac Radiol 2018; 47:20180100. [PMID: 29851369 DOI: 10.1259/dmfr.20180100] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess the influence of brightness and contrast adjustments of digital radiographs on the diagnosis of proximal caries lesions, and to compare with observers' preferences for subjective image quality. METHODS 80 proximal surfaces of posterior teeth were radiographed using an intraoral digital system (Digora Toto, Soredex, Finland). Initial images and four different combinations of brightness and contrast for each radiography were analysed. Five observers scored the images for the presence and extension of caries lesions. Micro-CT images were used as gold standard. In a second stage, the observers were asked which of the radiographs they preferred for the assessment of caries lesions. RESULTS No differences were found between the original and adjusted radiographic images regarding the area under the receiver operating characteristic curve, sensitivity, and specificity (p > 0.05). There was a significant difference between the micro-CT and the intraoral radiographs (p < 0.0001). Images with high brightness and low contrast presented higher number of true negative cases, but also a decrease in caries detection. On the other hand, there were more cases of overestimation of the presence and extension of caries lesions in images with low brightness and high contrast. The subjective evaluation of image quality showed that radiographs with lower brightness and higher contrast tended to be preferred by observers. CONCLUSIONS Brightness and contrast adjustments in digital intraoral radiographs within the range tested in this study do not significantly influence the diagnosis of proximal caries lesions, although observers tend to prefer lower brightness and higher contrast images.
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Affiliation(s)
- Eduarda Hl Nascimento
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
| | - Hugo Gaêta-Araujo
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
| | - Karla F Vasconcelos
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
| | - Bernardo B Freire
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
| | - Christiano Oliveira-Santos
- 2 Division of Oral Radiology, Department of Stomatology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP) , São Paulo , Brazil
| | - Francisco Haiter-Neto
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
| | - Deborah Q Freitas
- 1 Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP) , São Paulo , Brazil
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Hameed MH, Umer F, Khan FR, Pirani S, Yusuf M. Assessment of the diagnostic quality of the digital display monitors at the dental clinics of a university hospital. Informatics in Medicine Unlocked 2018. [DOI: 10.1016/j.imu.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Liukkonen E, Jartti A, Haapea M, Oikarinen H, Ahvenjärvi L, Mattila S, Nevala T, Palosaari K, Perhomaa M, Nieminen MT. Effect of display type and room illuminance in chest radiographs. Eur Radiol 2016; 26:3171-9. [PMID: 26662032 DOI: 10.1007/s00330-015-4150-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/19/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
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Kallio-Pulkkinen S, Huumonen S, Haapea M, Liukkonen E, Sipola A, Tervonen O, Nieminen MT. Effect of display type, DICOM calibration and room illuminance in bitewing radiographs. Dentomaxillofac Radiol 2015; 45:20150129. [PMID: 26234536 DOI: 10.1259/dmfr.20150129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare observer performance in the detection of both anatomical structures and caries in bitewing radiographs using consumer grade displays with and without digital imaging and communications in medicine (DICOM) calibration, tablets (third generation iPad; Apple, Cupertino, CA) and 6-megapixel (MP) displays under different lighting. METHODS 30 bitewing radiographs were blindly evaluated on four displays under bright (510 lx) and dim (16 lx) ambient lighting by two observers. The dentinoenamel junction, enamel and dentinal caries, and the cortical border of the alveolar crests were evaluated. Consensus was considered as reference. Intraobserver agreement was determined. The proportion of equivalent ratings and weighted kappa were used to assess reliability. RESULTS The proportion of equivalent ratings with consensus differed significantly between uncalibrated and DICOM-calibrated consumer grade display in enamel caries in upper and lower molars in bright (p = 0.013 and p = 0.003) lighting, and in dentinal caries in lower molars in both bright (p = 0.022) and dim (p = 0.004) lighting. The proportion also differed significantly between DICOM-calibrated consumer grade and 6-MP display in dentinal caries in lower molars in bright lighting (p = 0.039), tablet and consumer grade display in enamel caries in upper molars (p = 0.017) in bright lighting, tablet and 6-MP display in dentinal caries in lower molars (p = 0.003) in bright lighting and in enamel caries in lower molars (p = 0.012) in dim lighting. CONCLUSIONS DICOM calibration improves the detection of enamel and dentinal caries in bitewing radiographs, particularly in bright lighting. Therefore, a calibrated consumer grade display can be recommended as a diagnostic tool for viewing bitewing radiographs.
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Affiliation(s)
- Soili Kallio-Pulkkinen
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,2 Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Sisko Huumonen
- 3 Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland.,4 Department of Diagnostic Imaging, Turku University Hospital, Turku, Finland
| | - Marianne Haapea
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,2 Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Esa Liukkonen
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,2 Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Annina Sipola
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Osmo Tervonen
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,2 Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.,5 Unit of Medical Imaging, Physics and Technology Research, University of Oulu, Oulu, Finland
| | - Miika T Nieminen
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,2 Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.,5 Unit of Medical Imaging, Physics and Technology Research, University of Oulu, Oulu, Finland
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Kallio-Pulkkinen S, Haapea M, Liukkonen E, Huumonen S, Tervonen O, Nieminen MT. Comparison between DICOM-calibrated and uncalibrated consumer grade and 6-MP displays under different lighting conditions in panoramic radiography. Dentomaxillofac Radiol 2015; 44:20140365. [PMID: 25564888 DOI: 10.1259/dmfr.20140365] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare observer performance in the detection of anatomical structures and pathology in panoramic radiographs using consumer grade with and without digital imaging and communication in medicine (DICOM)-calibration and 6-megapixel (6-MP) displays under different lighting conditions. METHODS 30 panoramic radiographs were randomly evaluated on three displays under bright (510 lx) and dim (16 lx) ambient lighting by two observers with different years of experience. Dentinoenamel junction, dentinal caries and periapical inflammatory lesions, visibility of cortical border of the floor and pathological lesions in maxillary sinus were evaluated. Consensus between the observers was considered as reference. Intraobserver agreement was determined. Proportion of equivalent ratings and weighted kappa were used to assess reliability. The level of significance was set to p < 0.05. RESULTS The proportion of equivalent ratings with consensus differed between uncalibrated and DICOM-calibrated consumer grade displays in dentinal caries in the lower molar in dim lighting (p = 0.021) and between DICOM-calibrated consumer grade and 6-MP display in bright lighting (p = 0.038) for an experienced observer. Significant differences were found between uncalibrated and DICOM-calibrated consumer grade displays in dentinal caries in bright lighting (p = 0.044) and periapical lesions in the upper molar in dim lighting (p = 0.008) for a less experienced observer. Intraobserver reliability was better at detecting dentinal caries than at detecting periapical and maxillary sinus pathology. CONCLUSIONS DICOM calibration may improve observer performance in panoramic radiography in different lighting conditions. Therefore, a DICOM-calibrated consumer grade display can be used instead of a medical display in dental practice without compromising the diagnostic quality.
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Affiliation(s)
- S Kallio-Pulkkinen
- 1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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Kallio-Pulkkinen S, Haapea M, Liukkonen E, Huumonen S, Tervonen O, Nieminen MT. Comparison of consumer grade, tablet and 6MP-displays: observer performance in detection of anatomical and pathological structures in panoramic radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:135-41. [DOI: 10.1016/j.oooo.2014.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/21/2014] [Accepted: 04/08/2014] [Indexed: 11/29/2022]
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Hellén-Halme K, Lith A. Carious lesions: diagnostic accuracy using pre-calibrated monitor in various ambient light levels: an in vitro study. Dentomaxillofac Radiol 2013; 42:20130071. [PMID: 23775926 DOI: 10.1259/dmfr.20130071] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study investigated the effect of different monitor calibration modes under various ambient lighting conditions on the ability of observers to recognize proximal carious lesions of varying depths. METHODS 7 observers evaluated 100 teeth for proximal carious lesions on standardized digital radiographs using 3 set-ups: (1) pre-calibrated monitor for high ambient light (higher than 1000 lux), (2) pre-calibrated monitor for low ambient light (less than 50 lux) and (3) Barten calibration (Digital Imaging and Communication in Medicine) on the monitor in dimmed ambient light (less than 50 lux). Receiver operating characteristic curves were plotted for all observations. The criterion standard was histological examination of the teeth. The effects of three conditions were compared using a paired t-test. The level of significance was set to p < 0.05. RESULTS No significant difference was found in diagnostic accuracy for the detection of any type of proximal carious lesions between the different calibration modes of the monitor according to different ambient light levels. CONCLUSIONS There is no evidence that any difference between ambient light levels affects the ability to detect carious lesions in digital radiographs as long as the monitor was calibrated in accordance with the surrounding light level.
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Affiliation(s)
- K Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden.
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