Diagnostic Accuracy of Digital and Conventional Radiography in the Detection of Non-Cavitated Approximal Dental Caries

BACKGROUND: Radiography plays an important role in the detection of interproximal caries. OBJECTIVES: The aim of the present study was to determine diagnostic accuracy of chargecoupled devices (CCD), Photo Stimulable Phosphor (PSP) and film radiography in detecting non-cavitated caries. PATIENTS AND METHODS: Seventy-two non-cavitated approximal surfaces of extracted human posterior teeth were radiographed under standardized conditions using three intraoral modalities: CCD Dixi3 (Planmeca, Finland), PSP Digora PCT (Soredex, Finland),and E-speed film (Kodak, USA). Radiographs were interpreted by four observers and caries lesions were classified as sound (R0), restricted to enamel (R1), reaching the dentinoenamel junction (DEJ) and the outer half of the dentin (R2) and the inner half of the dentin (R3). The teeth were subsequently sectioned for histological analysis which served as the gold standard for radiographic examination. RESULTS: Microscopic examinations showed that the distribution of caries were 63.9% sound, 18.1% enamel, 9.7% DEJ and outer half of the dentin and 8.3% into the inner half of the dentin. The sensitivity and specificity of film, CCD and PSP for the detection of enamel caries were 38% and 98%; 15% and 96 %; and 23% and 98%, respectively. The sensitivity and specificity of film, CCD and PSP for the detection of both dentin and enamel caries were 55% and 100%; 45% and 100% ; and 55% and 100%, respectively. CONCLUSIONS: The results demonstrated that the diagnostic accuracy of digital images is similar to that of conventional film radiography in the detection of non-cavitated approximal caries.