Imaging Sci Dent.  2011 Dec;41(4):143-150. 10.5624/isd.2011.41.4.143.

Diagnostic performance of cone-beam computed tomography on detection of mechanically-created artificial secondary caries

• Charuakkra A
• Prapayasatok S
• Janhom A
• Pongsiriwet S
• Verochana
• Mahasantipiya P

• KMID: 2167398
• DOI: http://doi.org/10.5624/isd.2011.41.4.143

Abstract

PURPOSE
The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries.
MATERIALS AND METHODS
One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve (Az) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05).
RESULTS
The mean Az values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest Az value.
CONCLUSION
Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.

Keyword

Dental Caries; Cone Beam CT; Radiography, Bitewing; Diagnosis

MeSH Terms

Bicuspid
Cone-Beam Computed Tomography
Dental Caries
Humans
Molar
Radiography, Bitewing
ROC Curve
Steel
Tooth
Steel

Figure

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  Fig. 1 The illustration shows artificial caries prepared at the gingival floor and sealed with pink wax.

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  Fig. 2 Examples of CBCT images demonstrates either secondary caries present or absent. A. Axial plane. B. Coronal plane. C. Sagittal plane.

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  Fig. 3 Examples of bitewing images demonstrate either secondary caries present or absent

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  Fig. 4 ROC curves represent pooled radiographic scores for five observers diagnosing secondary caries in connection with imaging modalities.

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  Fig. 5 Examples of CBCT images in sagittal plane in which misinterpretation of secondary caries occurred. Thick arrows point at the surfaces that gave false positive results.

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  Fig. 6 The CBCT image in the sagittal plane shows the artifacts (arrow) from the adjacent amalgam restoration that could be misinterpreted as secondary or remnant caries.

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  Fig. 7 The Promax 3D system CBCT image (A) demonstrates a greater amount of artifacts than that of the Pax-500ECT system (B).

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