Arayüz çürüklerinin saptanmasında beş farklı tekniğin diagnostik doğruluğu

Yıl 2018, , 9 - 16, 12.09.2017

Defne Yalçın Yeler , Melike Koraltan

https://doi.org/10.17214/gaziaot.294870

Cited By: 1

Öz

Amaç: Bu çalışmanın amacı, beş farklı radyografik
görüntüleme yönteminin posterior dişlerde arayüz çürük teşhisindeki doğruluk
değerlerinin karşılaştırılmasıdır.

Gereç ve Yöntem: Çalışmada çürüklü ve
çürüksüz 72 adet posterior diş kullanıldı. Geleneksel bitewing radyograflar
intraoral film kullanılarak, dijital bitewing radyograflar ise fosfor plak
sistem kullanılarak alındı. Panoramik görüntüler dijital panoramik cihazın
bitewing, ortogonal ve standart programları kullanılarak elde edildi. Görüntüler
iki gözlemci tarafından değerlendirildi. Gözlemci içi ve gözlemciler arası uyum
ağırlıklandırılmış kappa katsayısı hesaplanarak belirlendi. Çürük tespitinde
altın standart kabul edilen histopatolojik skorlar ile beş yöntemden elde
edilen skorlara ROC analizi uygulandı. Yöntemlere ait Az değerleri z-testi ile
karşılaştırıldı ve anlamlılık düzeyi 0.05 olarak kabul edildi. Yöntemlere ait
sensitivite, spesifisite ve yanlış pozitif oranları hesaplandı.

Bulgular: Gözlemci içi ve gözlemciler arası uyuma ait κ değerleri sırasıyla 0.59-0.88 ve 0.54-0.87 arasında
değişti. ROC analizinde ortalama Az değerleri en yüksek olarak geleneksel
bitewing yönteminde (0.760) ve fosfor plak sisteminde (0.756), en düşük olarak ise
panoramik cihazın standart programında (0.639) bulundu. Standart panoramik
görüntüler çürük teşhisinde diğer yöntemlerden anlamlı olarak yetersiz bulundu
(p<0.05). Yöntemlerin sensitivite ve spesifisite değerleri sırasıyla;
geleneksel yöntem için 0.64-0.85, fosfor plak için 0.64-0.87, standart program
için 0.40-0.87, ortogonal program için 0.56-0.85, ekstraoral bitewing için
0.59-0.90 olarak bulundu.

Sonuç: Çalışmada geleneksel bitewing ve fosfor plak
bitewing görüntüleri benzer doğruluk düzeyine sahip bulundu. Panoramik
cihazdaki ortogonal ve bite-wing programların süperpozisyonların azaltılmasında
etkili olduğu gözlendi. Yöntemlerin mine çürüğü düzeyinde sensitiviteleri düşük
bulgulandı.

Anahtar Kelimeler

Isırtma radyografisi, panoramik radyografi, diş çürükleri

Diagnostic accuracy of five different techniques for detection of approximal caries

Öz

Objective: The aim of this study was to compare the accuracy of
five different radiographic methods for the detection of approximal caries on
posterior teeth.

Materials
and Method: Seventy-two extracted posterior
teeth with and without caries were studied. Intraoral bitewing radiographs were
taken with film and a storage phosphor-plate system. Extraoral panoramic images
were obtained by using the bitewing, orthogonal and standard programs of a
digital panoramic radiography device. Images were evaluated by two observers.
Intra- and inter-observer weighted-kappa coefficients were calculated. Scores
obtained from the five techniques were compared against the histological gold
standard using receiver operating characteristics (ROC) curve analysis. Az
values for each image type were compared using z-test and the level of
statistical significance was set at 0.05. Sensitivity, specificity and
false-positive rates were calculated for each method.

Results: Intra- and inter-observer agreement κ values were between 0.59-0.88 and 0.54-0.87,
respectively. The Az value was greatest with conventional bitewing (0.760) and
phosphor plate bitewing (0.756) and lowest with standard panoramic image program
(0.639). The standard panoramic image program was significantly inferior to the
other diagnostic methods (p<0.05).
Sensitivity and specificity values were 0.64 and 0.85
for conventional bitewing, 0.64 and 0.87 for phosphor plate bitewing, 0.40 and
0.87 for standard program, 0.56 and 0.85 for orthogonal program, and 0.59 and
0.90 for extraoral bitewing program, respectively.

Conclusion: In this study, conventional and phosphor plate
bitewing images were found to confer similar diagnostic accuracy. Orthogonal
and extraoral bitewing programs on panoramic devices were effective for
reducing superimpositions. The diagnostic sensitivity of the studied methods
for approximal caries was found to be low at the level of enamel.

Anahtar Kelimeler

Bitewing radiography, panoramic radiography, dental caries

Kaynakça

• Cawson RA, Odell EW, Porter SR. Cawson’s essentials of oral pathology and oral medicine, 7th edn. New York: Churchill Livingstone; 2002.
• Bottenberg P, Jacquet W, Stachniss V, Wellnitz J, Schulte AG. Detection of cavitated or non-cavitated approximal enamel caries lesions using CMOS and CCD digital X-ray sensors and conventional D and F-speed films at different exposure conditions. Am J Dent 2011;24:74-8.
• Manton DJ. Diagnosis of the early caries lesion. Aust Dent J 2013;58:35-9.
• Svanaes DB, Moystad A, Larheim TA. Approximal caries depth assessment with storage phosphor versus film radiography. Evaluation of the caries-specific Oslo enhancement procedure. Caries Res 2000;34:448-53.
• Bloemendal E, de Vet HC, Bouter LM. The value of bitewing radiographs in epidemiological caries research: a systematic review of the literature. J Dent 2004;32:255-64.
• Poorterman JH, Aartman IH, Kieft JA, Kalsbeek H. Value of bite-wing radiographs in a clinical epidemiological study and their effect on the DMFS index. Caries Res 2000;34:159-63.
• Ağlarcı OS, Yılmaz HH. Diş hekimliğinde dijital radyografi. Süleyman Demirel Üniv Diş Hek Fak Derg 2010:45-52.
• Wenzel A. Bitewing and digital bitewing radiography for detection of caries lesions. J Dent Res 2004;83:C72–5.
• Dowsett D, Kenny PA, Johnston RE. The Physics of Diagnostic Imaging, 2nd edn. London: CRC Press; 2006.
• Akkaya N, Kansu O, Kansu H, Cagirankaya LB, Arslan U. Comparing the accuracy of panoramic and intraoral radiography in the diagnosis of proximal caries. Dentomaxillofac Radiol 2006;35:70-4.
• Pillai KG. Oral & Maxillofacial Radiology: Basic Principles and Interpretation, 1st edn. Delhi: Jaypee Brothers Medical Publishers; 2015.
• Noujeim M, Prihoda T, McDavid WD, Ogawa K, Seki K, Okano T, et al. Pre-clinical evaluation of a new dental panoramic radiographic system based on tomosynthesis method. Dentomaxillofac Radiol 2011;40:42–6.
• Ogawa K, Langlais RP, McDavid WD, Noujeim M, Seki K, Okano T, et al. Development of a new dental panoramic radiographic system based on a tomosynthesis method. Dentomaxillofac Radiol 2010;39:47-53.
• Kamburoglu K, Kolsuz ME, Murat S, Yüksel S, Ozen T. Proximal caries detection accuracy using intraoral bitewing radiography, extraoral bitewing radiography and panoramic radiography. Dentomaxillofac Radiol 2012;41:450-9.
• Scarfe WC, Langlais RP, Nummikoski P, Dove SB, McDavid WD, Deahl ST, et al. Clinical comparison of two panoramic modalities and posterior bite-wing radiography in the detection of proximal dental caries. Oral Surg Oral Med Oral Pathol 1994;77:195-207.
• Senel B, Kamburoglu K, Ucok O, Yüksel SP, Ozen T, Avsever H. Diagnostic accuracy of different imaging modalities in detection of proximal caries. Dentomaxillofac Radiol 2010;39:501-11.
• Silva Neto JM, dos Santos RL, Sampaio MC, Sampaio FC, Passos IA. Radiographic diagnosis of incipient proximal caries: an ex-vivo study. Braz Dent J 2008;19:97-102.
• Abesi F, Mirshekar A, Moudi E, Seyedmajidi M, Haghanifar S, Haghighat N, et al. Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries. Iran J Radiol 2012;9:17-21.
• Hintze H, Wenzel A. Diagnostic outcome of methods frequently used for caries validation. A comparison of clinical examination, radiography and histology following hemisectioning and serial tooth sectioning. Caries Res 2003;37:115-24.
• Syriopoulos K, Sanderink GC, Velders XL, van der Stelt PF. Radiographic detection of proximal caries: a comparison of dental films and digital imaging systems. Dentomaxillofac Radiol 200;29:312-8.
• Kielbassa AM, Paris S, Lussi A, Meyer-Lueckel H. Evaluation of cavitations in proximal caries lesions at various magnification levels in vitro. J Dent 2006;34:817-22.
• Alkurt MT, Peker I, Bala O, Altunkaynak B. In vitro comparison of four different dental X-ray films and direct digital radiography for proximal caries detection. Oper Dent 2007;32:504-9.
• Haak R, Wicht MJ, Noack MJ. Conventional, digital and contrast-enhanced bitewing radiographs in the decision to restore approximal caries lesions. Caries Res 2001;35:193-9.
• Hintze H, Wenzel A. Influence of the validation method on diagnostic accuracy for caries. A comparison of six digital and two conventional radiographic systems. Dentomaxillofac Radiol 2002;31:44-9.
• Civera VG, Silla JM, Company JM, Navarro LP. Clinical and radiographic diagnosis of approximal and occlusal dental caries in a low risk population. Med Oral Pathol Oral Cir Bucal 2007;12:E252-7.
• Møystad A, Svanaes DB, Risnes S, Larheim TA, Gröndahl HG. Detection of approximal caries with a storage phosphor system. A comparison of enhanced digital images with dental X-ray film. Dentomaxillofac Radiol 1996;25:202-6.
• Castro VM, Katz JO, Hardman PK, Glaros AG, Spencer P. In vitro comparison of conventional film and direct digital imaging in the detection of approximal caries. Dentomaxillofac Radiol 2007;36:138-42.
• Mohtavipour ST, Shahsavari F, Haghighat, ASJ, Mohtavipour SS, Malekshoar M. In vitro comparison of conventional film and direct digital radiography in proximal caries detection. J Dent Dentomaxillofac Radiol Pathol Surg 2013;1:1-5.
• Eli I, Weiss EI, Tzohar A, Littner MM, Gelernter I, Kaffe I. Interpretation of bitewing radiographs. Part 1. Evaluation of the presence of approximal lesions. J Dent 1996;24:379-83.
• Weiss EI, Tzohar A, Kaffe I, Littner MM, Gelernter I, Eli I. Interpretation of bitewing radiographs, Part 2. Evaluation of the size of approximal lesions and need for treatment. J Dent 1996;24:385-8.
• Pontual AA, de Melo DP, de Almeida SM, Boscolo FN, Haiter Neto F. Comparison of digital systems and conventional dental film for the detection of approximal enamel caries. Dentomaxillofac Radiol 2010;39:431-6.
• Akarslan ZZ, Akdevelioglu M, Güngör K, Erten H. A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximal caries detection in posterior teeth. Dentomaxillofac Radiol 2008;37:458-63.