ABSTRACT
OBJECTIVES: The aim of this study was to determine the diagnostic accuracy of cone beam computed tomography (CBCT) in the detection of approximal and occlusal noncavitated carious lesions. METHODS: A total of 135 extracted human posterior teeth were used. They were radiographed using the following: conventional film (Kodak Insight), a digital system (PSP plates Digora Optime, Soredex), and a CBCT system (NewTom 3G, Quantitative Radiology). All the images were assessed by two independent observers twice. Receiver operating characteristic analysis (Az) was used. RESULTS: NewTom 3G 9â³ CBCT was statistically inferior to conventional film and a digital system for the detection of approximal caries. NewTom 3G 9â³ had significantly higher Az values than PSP plate (p < 0.05), but there were no statistically significant differences between the Az values for CBCT and film (p > 0.33) for occlusal surface caries. CONCLUSION: The diagnostic accuracy of all three tested radiographic systems is low, and it is necessary to use other methods to improve early caries detection. CLINICAL RELEVANCE: CBCT has found a wide application in different fields of dentistry. The report from a CBCT examination performed for any of these reasons should include all abnormal findings, and the detection of noncavitated caries lesions is especially important because it facilitates the use of noninvasive treatment.
Subject(s)
Cone-Beam Computed Tomography/methods , Dental Caries/diagnostic imaging , Radiography, Dental, Digital/methods , Bicuspid/diagnostic imaging , Humans , In Vitro Techniques , Molar/diagnostic imaging , Sensitivity and SpecificityABSTRACT
OBJECTIVES: The aim of this CBCT investigation on the detection of caries was to assess the influence of artefacts produced by the presence of amalgam fillings located in the vicinity. METHODS: 102 non-cavitated pre-molar and molar teeth were placed in blocks of silicone with approximal contacts consisting of 3 sound or carious teeth and 1 mesial-occlusal-distal amalgam-filled tooth in-between. Radiographs of all the teeth were recorded using the CBCT system (NewTom™ 3G; QR Srl, Verona, Italy; field of view, 9 inches). Data from the CBCT unit were reconstructed and sectioned in the mesiodistal tooth plane. Images were evaluated twice by two observers, using a five-step confidence scale. After the CBCT examination, the teeth were individually sectioned in the mesiodistal direction with a diamond saw. Using a light microscope at ×40 magnification, the true morphological status of all approximal surfaces was established. RESULTS: Sensitivity of the CBCT for the detection of caries on surfaces located proximally and distally to an amalgam filing ranged from 0.27 to 0.30 for enamel and from 0.47 to 0.56 for dentin. Specificity values for enamel proximal and distal lesions were 0.48 and 0.53, respectively, for enamel and 0.33 to 0.38, respectively, for proximal and distal dentin cases. Intra-observer reliability was 0.84, and interobserver reliability was 0.49. CONCLUSIONS: Owing to its low specificity, scans from a CBCT examination should not be used to determine the presence of demineralization of the tooth surface when amalgam fillings are present in the region of interest.
