Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea.
Department of Preventive Dentistry & Public Oral Health, Yonsei University College of Dentistry, Seoul, Korea.
Dentomaxillofac Radiol. 2020 Dec 1;49(8):20190467. doi: 10.1259/dmfr.20190467. Epub 2020 May 4.
The aim of this study is to introduce a novel program of panoramic radiography that shows 41 multilayer images from the buccal to lingual aspects in a region of interest, and to evaluate the effectiveness of this program for detecting proximal caries.
In total, 480 premolars and molars on 30 panoramic radiographs taken with the multilayer imaging program were included in this study. The presence or absence of caries in 960 proximal surfaces was assessed by three experienced oral and maxillofacial radiologists as a consensus-based gold-standard. Two general dentists evaluated and scored proximal caries on 980 surfaces on panoramic radiographs with and without the multilayer imaging program. The two general dentists' scores were compared with the gold-standard, and were analyzed for sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic (ROC) curve with and without using the program. The area under the ROC curve was analyzed using STATA/SE 13.1.
When the multilayer imaging program was used for panoramic radiography, the inter- and intraobserver agreement of the two general dentists improved. All values, including the area under the ROC curve, were higher when the multilayer imaging program was used than when it was not used. The area under the ROC curve showed a statistically significant improvement only in Observer 1, whose diagnostic ability was poorer than that of Observer 2.
O: This multilayer imaging program might help the inexperienced dentist to improve the diagnostic accuracy of proximal caries. If further studies would be performed in various clinical application, it could be useful when intraoral radiography taking is difficult for reasons such as mouth-opening limitations and the gag reflex of the patients.
本研究旨在介绍一种新的全景放射摄影程序，该程序可在感兴趣区域内从颊侧到舌侧显示 41 层多层图像，并评估该程序在检测邻面龋中的有效性。
本研究共纳入 30 张使用多层成像程序拍摄的全景片上的 480 颗前磨牙和磨牙。960 个近中面的龋病存在与否由 3 名经验丰富的口腔颌面放射科医生进行评估，并达成共识作为金标准。两名普通牙医在使用和不使用多层成像程序的情况下，对 980 个近中面的龋病进行评估和评分。将两名普通牙医的评分与金标准进行比较，并分析使用和不使用程序时的敏感性、特异性、阳性预测值、阴性预测值和接收者操作特征（ROC）曲线下面积。使用 STATA/SE 13.1 分析 ROC 曲线下面积。
当在全景放射摄影中使用多层成像程序时，两名普通牙医的观察者间和观察者内一致性得到提高。当使用多层成像程序时，所有值，包括 ROC 曲线下面积，均高于不使用时的值。仅在观察者 1 中，ROC 曲线下面积显示出统计学上的显著改善，而观察者 1的诊断能力低于观察者 2。
这种多层成像程序可能有助于经验不足的牙医提高邻面龋的诊断准确性。如果在各种临床应用中进行进一步研究，当由于患者张口受限和咽反射等原因导致口腔内放射摄影困难时，它可能会很有用。
