Diagnostic accuracy of different display types in detection of recurrent caries under restorations by using CBCT

Abstract

Objectives: To assess the in vitro diagnostic ability of CBCT images using seven different display types in the detection of recurrent caries. Methods: Our study comprised 128 extracted human premolar and molar teeth. 8 groups each containing 16 teeth were obtained as follows: (1) Black Class I (Occlusal) amalgam filling without caries; (2) Black Class I (Occlusal) composite filling without caries; (3) Black Class II (Proximal) amalgam filling without caries; (4) Black Class II (Proximal) composite filling without caries; (5) Black Class I (Occlusal) amalgam filling with caries; (6) Black Class I (Occlusal) composite filling with caries; (7) Black Class II (Proximal) amalgam filling with caries; and (8) Black Class II (Proximal) composite filling with caries. Teeth were imaged using 100 3 90 mm field of view at three different voxel sizes of a CBCT unit (Planmeca ProMax ® 3D ProFaceÔ; Planmeca, Helsinki, Finland). CBCT TIFF images were opened and viewed using custom-designed software for computers on different display types. Intraand interobserver agreements were calculated. The highest area under the receiver operating characteristic curve (Az) values for each image type, observer, reading and restoration were compared using z-tests against Az 5 0.5. The significance level was set at p 5 0.05. Results: We found poor and moderate agreements. In general, Az values were found when software and medical diagnostic monitor were utilized. For Observer 2, Az values were statistically significantly higher when software was used on medical monitor [p 5 0.036, p 5 0.015 and p 5 0.002, for normal-resolution mode (0.200 mm 3 voxel size), high-resolution mode (0.150 mm 3 voxel size) and low-resolution mode (0.400 mm 3 voxel size), respectively]. No statistically significant differences were found among other display types for all modes (p . 0.05). In general, no difference was found among 3 different voxel sizes (p . 0.05). In general, higher Az values were obtained for composite restorations than for amalgam restorations for all observers. For Observer 1, Az values for composite restorations were statistically significantly higher than those of amalgam restorations for MacBook and iPhone (Apple Inc., Cupertino, CA) assessments (p 5 0.002 and p 5 0.048, respectively). Conclusions: Higher Az values were observed with medical monitors when used with dedicated software compared to other display types which performed similarly in the diagnosis of recurrent caries under restorations. In addition, observers performed better in detection of recurrent caries when assessing composite restorations than amalgams.

Performance of 5 different displays in the detection of artificial incipient and recurrent caries-like lesions

“…The beam hardening and/or starvation would hinder the diagnostic accuracy of the images. 21 In our study, we did not find a statistical significant difference between the amalgam and composite recurrent detection accuracy; however we evaluated two dimensional images which do not generate tomographic artifacts.…”

“…Baltacioĝlu et al 21 showed that, when viewing the more advanced images generated by CBCT, the medical grade monitors resulted in the highest accuracy for secondary caries detection. They compared sets of TIFF images of a CBCT scan on a variety of monitor types ranging from laptops to smartphones.…”

Influence of Different Bioactive Tooth Colored Restorative Materials in Caries Detection Using Cone Beam Computed Tomography

“…Recurrent caries is once in a while observed on occlusal surfaces of the teeth that those edges are effortlessly cleaned. Strikingly, around 50 to 60% of restorations are supplanted on account of a determination of recurrent caries [1][2][3][4][5][6].…”

“…The quick improvement of innovation has brought forth different advanced dental imaging modalities, including digital intraoral radiography and cone beam computerized tomography (CBCT) scanners. CBCT has made storming in maxillofacial imaging, encouraging the progress of dental determination from 2D to 3D pictures and extending the part of imaging from finding to imaging guidance of operative and surgical systems by utilization of outsider programming [2][3][4][5][6][7][8][9][10][11].…”

Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth

“…Beamhardening artifacts occur adjacent to high density structures and are seen as dark bands, and streak artifacts occur due to radiation from a metallic object and are seen as linear hyper-densities extending along the width of the field 12. The presence of beam-hardening artifacts and streak artifacts has the potential to completely affect the quality of the CBCT image and, thus, its diagnostic ability.…”