da Fonte Juliana B Melo, Pita de Melo Daniela, Fugolin Ana Paula Piovezan, Sousa Melo Saulo
Division of Oral and Maxillofacial Diagnostic Sciences, School of Dental Medicine, University of Connecticut, Farmington, CT, USA.
College of Dentistry, University of Saskatchewan, 107 Wiggins Road, E3332 HSc, Saskatoon, SK, S7N5E5 , Canada.
Clin Oral Investig. 2025 Jun 3;29(6):329. doi: 10.1007/s00784-025-06400-7.
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.
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).
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.
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.
The novel CMOS sensor, based on direct conversion technology, has shown promise in enhancing diagnostic performance and improving clinical outcomes for noncavitated caries lesions.
比较三种口腔内互补金属氧化物半导体（CMOS）传感器的诊断性能，其中一种基于直接转换（CMOS-DC），另外两种是依赖闪烁体的传感器，用于评估非龋洞样病变。
选取60颗拔除的无龋人类牙齿（30颗前磨牙，30颗磨牙）。使用脱矿溶液在15颗前磨牙（dPM）的远中面和15颗磨牙（dM）的近中面诱导龋样病变，其余牙齿保持完好（sPM，sM）。模型以4种组合方式安装：dPM-dM、dPM-sM、sPM-dM和sPM-sM。使用一个CMOS-DC传感器（XpectVision XVD2530）和两个传统的依赖闪烁体的CMOS传感器（CMOS-C1：Dexis IXS，以及CMOS-C2：Carestream RVG-6200）获得标准化的X线片。三名经过校准的观察者使用5分制独立评估图像。使用Kappa检验、方差分析和Tukey检验（p≤0.05）分析观察者间的一致性、敏感性、特异性、准确性和曲线下面积（AUC）。
观察者内和观察者间的一致性从中等到完美。特异性（70.57 - 83.35）、准确性（64.98 - 71.10）和AUC（72.63 - 78.00）无统计学显著差异（p>0.05）。CMOS-DC传感器的敏感性显著高于CMOS-C2（p = 0.017）。在所有传感器中，dPM的敏感性更高，在CMOS-C1和CMOS-DC传感器上dPM的AUC值更高。
新型CMOS-DC传感器的表现与更常用的传感器相当，在诊断真正存在的龋样病变时敏感性略高。
基于直接转换技术的新型CMOS传感器在提高非龋洞样龋病变的诊断性能和改善临床结果方面显示出前景。
