Performance of a novel direct-conversion intraoral sensor on the assessment of caries-like lesions - an ex-vivo comparison with conventional (scintillator-dependent) intraoral sensors.

OBJECTIVES

To compare the diagnostic performance of three intraoral complementary metal-oxide-semiconductor (CMOS) sensors, one based on direct conversion (CMOS-DC) and two scintillator-dependent sensors, in assessing noncavitated caries-like lesions.

MATERIALS AND METHODS

Sixty extracted human caries-free teeth (30 premolars, 30 molars) were selected. A demineralizing solution was used to induce caries-like lesions on the distal surface of 15 premolars (dPM) and the mesial surface of 15 molars (dM), while the remaining teeth were kept sound (sPM, sM). Phantoms were mounted in 4 combinations: dPM-dM, dPM-sM, sPM-dM, and sPM-sM. Standardized radiographs were obtained with one CMOS-DC sensor (XpectVision XVD2530) and two conventional scintillator-dependent CMOS sensors (CMOS-C1: Dexis IXS, and CMOS-C2: Carestream RVG-6200). Three calibrated observers independently assessed the images using a 5-point scale. Observers' agreement, sensitivity, specificity, accuracy and area under the curve (AUC) were analyzed using Kappa, ANOVA, and Tukey test (p ≤ 0.05).

RESULTS

Intra- and interobserver agreements ranged from fair to perfect. Specificity (70.57-83.35), accuracy (64.98-71.10), and AUC (72.63-78.00) showed no statistically significant differences (p > 0.05). The CMOS-DC sensor demonstrated significantly higher sensitivity than CMOS-C2 (p = 0.017). Across all sensors, sensitivity was greater for dPM, with higher AUC values for dPM on CMOS-C1 and CMOS-DC sensors.

CONCLUSIONS

The novel CMOS-DC sensor performed comparably to the more commonly used sensors, with slightly superior sensitivity in diagnosing caries-like lesions when those were truly present.

CLINICAL RELEVANCE

The novel CMOS sensor, based on direct conversion technology, has shown promise in enhancing diagnostic performance and improving clinical outcomes for noncavitated caries lesions.