GalvÃo Neiandro Santos, Nascimento Eduarda Helena Leandro, GaÊta-Araujo Hugo, Freitas Deborah Queiroz, Haiter-Neto Francisco, Oliveira Matheus Lima
Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil.
Braz Oral Res. 2020;34:e082. doi: 10.1590/1807-3107bor-2020.vol34.0082. Epub 2020 Aug 7.
This study aims to assess the influence of high-density material on the radiographic diagnosis of proximal caries in digital systems with automatic exposure compensation, and to evaluate the effect of subjective adjustment of brightness and contrast to undertake this diagnostic task. Twenty bitewing radiographs of forty posterior human teeth with non-cavitated carious lesions, confirmed by micro-CT, were obtained with two digital systems. A porcelain-fused-to-metal crown attached to a titanium implant was inserted into the exposed area, and all the radiographs were repeated. Five radiologists assessed the radiographs and diagnosed proximal carious lesions. Afterwards, the observers were asked to adjust image brightness and contrast, based on their subjective perception, and to reassess the images. Thirty percent of each experimental group was reassessed to test intraobserver reproducibility, totaling 208 images per observer. Intraobserver and interobserver agreements ranged from fair to substantial. Sensitivity, specificity, predictive values, and area under the ROC curve were calculated and compared for each radiographic system, using ANOVA (α = 0.05). Overall, presence of high-density material and adjustment of brightness and contrast did not significantly influence the radiographic diagnosis of proximal caries (p ≥ 0.05). Regarding Digora Optime, adjustment of brightness and contrast significantly increased (p < 0.05) the diagnostic accuracy of proximal carious lesions in the presence of high-density material. In conclusion, the presence of high-density material in the X-rayed region does not influence radiographic diagnosis of proximal caries. However, when it is present in the X-rayed area, subjective adjustment of brightness and contrast is recommended for use with the Digora Optime digital system.
本研究旨在评估高密度材料对具有自动曝光补偿功能的数字系统中邻面龋X线诊断的影响，并评估主观调整亮度和对比度对进行该诊断任务的效果。使用两种数字系统获得了经显微CT证实的40颗后牙非龋性病变的20张咬合翼片X线片。将一个附着在钛种植体上的烤瓷熔附金属冠插入曝光区域，并重复拍摄所有X线片。5名放射科医生对X线片进行评估并诊断邻面龋病变。之后，要求观察者根据其主观感受调整图像亮度和对比度，并重新评估图像。每个实验组的30%进行重新评估以测试观察者内重复性，每位观察者总计208张图像。观察者内和观察者间一致性范围为一般至高度一致。使用方差分析（α = 0.05）计算并比较每个X线摄影系统的敏感性、特异性、预测值和ROC曲线下面积。总体而言，高密度材料的存在以及亮度和对比度的调整对邻面龋的X线诊断没有显著影响（p≥0.05）。对于Digora Optime系统，在存在高密度材料的情况下，亮度和对比度的调整显著提高了（p < 0.05）邻面龋病变的诊断准确性。总之，X线照射区域中高密度材料的存在不影响邻面龋的X线诊断。然而，当X线照射区域存在高密度材料时，建议对Digora Optime数字系统进行亮度和对比度的主观调整。
