Performance of digital radiography with enhancement filters for the diagnosis of proximal caries

Abstract

Enhancement filters are potentially supposed to improve the diagnostic performance of digital images. Thus, the aim of this study was to compare the performance of digital radiography with and without enhancement filters for the detection of induced proximal caries lesions. The total sample consisted of 120 sound human teeth (40 premolars, 80 molars). Enamel subsurface demineralization was induced in one of the proximal surfaces of 60 teeth. Standardized radiographs of all teeth were acquired after the demineralization phase using the Digora-Optime  system. Four radiologists examined the digital radiographs and applied the following filters provided by the Digora  for Windows 2.6 package: Negative, Sharpen and both (Negative plus Sharpen). Validation of radiographic diagnosis was carried out by Knoop cross-sectional microhardness profiling on the proximal surfaces. Intraobserver agreement was estimated using Kappa statistics (k). Sensitivity, specificity and overall accuracy were compared using ANOVA/Tukey test (a = 5%). Intraobserver agreement ranged from good to very good/optimal (k: 0.65-0.83). Although not statistically significant, the highest sensitivity (0.68 ± 0.22) and accuracy (0.76 ± 0.16) values were observed using the Sharpen filter as opposed to the Negative filter, which presented the lowest performance indices (0.57 ± 0.13 and 0.70 ± 0.10, respectively). Specificity ranged from 0.84 to 0.85, considering all imaging modalities (p > 0.05). Insofar as the Sharpen filter had the highest performance indices, it may be considered a useful adjunct for detecting subtle proximal caries lesions.

Influence of Image Filters and Variation in Horizontal Angle of Incidence of X-ray Beam in Digital Interproximal Radiographs for Diagnosis of Secondary Caries in Esthetic Restorations

“…As seen in the results presented in the present manuscript, the application of different radiographic filters did not result in an improvement in the diagnosis of caries, corroborating the results found by Takeshita et al 3 Haiter-Neto et al 13 Booshehry et al 17 Belém et al 19 and…”

“…An advantage of the ROC analysis is that it reflects the diagnostic performance of the method based on sensitivity and specificity. 5,11,19 These groups were evaluated by three examiners, specialists in Dental Radiology and Imaging Exams, suing the scale of evaluation, whose data were submitted to the Kappa interexaminer (KW = 0.799) and intraexaminer tests: examiner A (KW = 0.817), examiner B (KW = 0.931) and examiner C (KW = 0.841). In order to interpret these results Landis and Koch, 20 presented a scale that goes from < 0 up to 1.00, with the interval between 1.00 and 0.81 representing almost perfect agreement and between…”

Diagnostic Accuracy of Image Enhancement in Intra-Oral Direct Digital Radiography in the Assessment of Interproximal Caries

“…Negative, sharpen and both were applied to enhance images. The authors reported that the sharpen filter demonstrated the highest performance indices, and so it may be considered a useful adjunct for detecting subtle proximal caries lesions (17). Given this, we used the sharpen filter to compare with emboss; the other studies are about other filter enhancements.…”

Effect of Zooming, Colorization, and Contrast Conversion on Proximal Caries Detection

“…Despite the increasing popularity of digital radiography, only a few patients have benefitted from its perks because of the fact that many capabilities of these systems are ignored and not routinely used (15)(16)(17)(18). Some studies mentioned this ability and emphasized more on the agreement among observers (8-10); concurrently, some denied this objective and reported no difference in detecting subsurface proximal demineralization with various modalities (19,20). Haiter-Neto et al (2009) (11) reported no difference in detection potential between raw images of PSP and those processed with task-specific filters, but they recommended the application of fine enhancement for initial slight caries detection even if there is no considerable effect on diagnostic accuracy.…”

“…However, this supposition requires more investigation. Belem et al (2013) (20) evaluated the impaction of enhanced digital radiography in proximal caries detection and reported increased sensitivity and accuracy with sharpening; however, they found that negative filtering led to a decrease in accuracy. Mehr-Alizadeh et al (2012) (22) also reported increased sensitivity, positive predictive value, negative predictive value, and diagnostic accuracy of the zoomed images rather than the basics in their study on the diagnostic accuracy of dentinal occlusal caries detection.…”