Anbiaee Najmeh, Mohassel Anousheh Rashad, Imanimoghaddam Mahrokh, Moazzami Seyed Mostafa
Department of Maxillofacial Radiology of the School of Dentistry, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
J Contemp Dent Pract. 2010 Dec 1;11(6):E025-32.
The purpose of this laboratory research was to compare the accuracy of digital and conventional bitewing radiographs in the diagnosis of recurrent caries under class II amalgam restorations.
This study involved 82 posterior intact teeth in which class II amalgam boxes were prepared. Carious lesions were simulated in half of the proximal boxes in the intersection between the facial or lingual wall and the gingival floor or midway between the facial and lingual walls. The other half of each tooth specimen served as a control. The prepared boxes were then restored with a Tytin FC (Kerr, USA) amalgam. The teeth were radiographed in the bucco-lingual direction to obtain images comparable to bitewing. Digital radiographs made with an intraoral CCD sensor and conventional radiography with dental E film were used. Three expert observers evaluated both types of images for the diagnosis of recurrent caries.
Sensitivity and specificity values for direct digital radiography were 73 and 95 percent at the buccal and lingual line angles, respectively, and 29 and 90 percent at the mid-gingival floor, respectively. These corresponding values for conventional radiography were respectively 63 and 93 percent at the buccal line angle, 61 and 93 percent at the lingual line angle, and 44 and 95 percent at the mid-gingival floor. The total sensitivity and specificity values were 58 and 93 percent for digital radiography and 56 and 93 percent for conventional radiography. The overall accuracy was 76 percent for digital and 75 percent for conventional radiography. No significant difference in specificity or sensitivity was found between the digital and conventional radiography (p=0.104). Separately, no significant difference was seen between the buccal line angle and the mid-gingival floor, but a significant difference was seen between the two methods in the lingual line angle (p=0.004).
The digital and conventional bitewing radiographs had similar diagnostic accuracy for the diagnosis of recurrent caries. Lesions located at the buccal or lingual line angle were more easily detected than those at the mid-gingival region.
Although there was no significant difference between digital and conventional radiography in the diagnosis of recurrent caries, digital radiography requires less ionizing radiation, making this method of imaging suggested for routine dental practice.
本实验室研究的目的是比较数字式和传统咬合翼片在诊断Ⅱ类银汞合金修复体下复发性龋方面的准确性。
本研究涉及82颗完整的后牙，在这些牙齿上制备了Ⅱ类银汞合金窝洞。在近中窝洞的一半中，于颊侧或舌侧洞壁与龈缘或颊舌侧洞壁中间的相交处模拟龋损。每颗牙齿标本的另一半作为对照。然后用Tytin FC（美国 Kerr公司）银汞合金修复制备好的窝洞。将牙齿在颊舌向进行X线摄影以获得类似于咬合翼片的图像。使用口腔内CCD传感器进行数字X线摄影以及使用牙科E线胶片进行传统X线摄影。三位专家观察者对两种类型的图像进行复发性龋的诊断评估。
直接数字X线摄影在颊侧和舌侧龈缘角处的敏感度和特异度值分别为73%和95%，在龈缘中部则分别为29%和90%。传统X线摄影在颊侧龈缘角处的相应值分别为63%和93%，在舌侧龈缘角处为61%和93%，在龈缘中部为44%和95%。数字X线摄影的总敏感度和特异度值分别为58%和93%，传统X线摄影为56%和93%。数字X线摄影的总体准确性为76%，传统X线摄影为75%。数字式和传统X线摄影在特异度或敏感度方面未发现显著差异（p = 0.104）。单独来看，颊侧龈缘角和龈缘中部之间未发现显著差异，但在舌侧龈缘角处两种方法之间存在显著差异（p = 0.004）。
数字式和传统咬合翼片在诊断复发性龋方面具有相似的诊断准确性。位于颊侧或舌侧龈缘角处的病损比龈缘中部的病损更容易被检测到。
虽然数字式和传统X线摄影在复发性龋的诊断上没有显著差异，但数字X线摄影所需的电离辐射较少，因此建议在常规牙科实践中采用这种成像方法。
