Direct digital imaging with and without niobium filtration for detection of density differences beneath steel orthodontic bands.

An in vitro investigation was carried out to determine the efficacy of the RVG 32000 (Trophy Radiologie, Vincennes, France) in detecting subtle density variations in a standard aluminum test object through steel orthodontic bands. The density variations were of the same magnitude as those found when dental caries develops beneath bands during orthodontic therapy. The procedure was carried out with both standard aluminum filtration and added niobium filtration. This study revealed the imaging system to have a wide recording latitude with no significant differences in the diagnostic decisions being made between with entrance doses ranging from 189-517 microGy without niobium, and 169-267 microGy with added niobium. No significant difference was found between the diagnostic yield of images made with and without added niobium filtration. The accuracy was 89% with added niobium and 90% without added niobium. Specificity was 99% for both filtration conditions. It was generally possible to detect defects as small as 0.2-0.3 mm in 7 mm of aluminum through 0.26 mm steel orthodontic band material. It is concluded that the RVG 32000 has a wide recording latitude which permits detection of small density changes beneath orthodontic band material. The addition of niobium filtration did not interfere with this diagnostic task.