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Oral Radiology

Open Access 29-04-2024 | Caries | Original Article

Eligibility of a novel BW + technology and comparison of sensitivity and specificity of different imaging methods for radiological caries detection

Authors: Kathrin Becker, Henrike Ehrlich, Mira Hüfner, Nicole Rauch, Caroline Busch, Beryl Schwarz-Herzke, Dieter Drescher, Jürgen Becker

Published in: Oral Radiology

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Abstract

Objectives

Bitewing radiography is considered to be of high diagnostic value in caries detection, but owing to projections, lesions may remain undetected. The novel bitewing plus (BW +) technology enables scrolling through radiographs in different directions and angles. The present study aimed at comparing BW + with other 2D and 3D imaging methods in terms of sensitivity, specificity, and user reliability.

Materials and methods

Five human cadavers were used in this study. In three cadavers, natural teeth were transplanted post-mortem. BW + , two-dimensional (digital sensors, imaging plates, 2D and 3D bitewing radiographs) and 3D methods (high and low dose CBCT) were taken. Carious lesions were evaluated on 96 teeth at three positions (mesial, distal, and occlusal) and scored according to their level of demineralization by ten observers, resulting in 35,799 possible lesions across all observers and settings. For reference, µCT scans of all teeth were performed.

Results

Overall, radiographic evaluations showed a high rate of false-negative diagnoses, with around 70% of lesions remaining undetected, especially enamel lesions. BW + showed the highest sensitivity for dentinal caries and had comparatively high specificity overall.

Conclusions

Within the limits of the study, BW + showed great potential for added diagnostic value, especially for dentinal caries. However, the tradeoff of diagnostic benefit and radiation exposure must be considered according to each patient’s age and risk.
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Metadata
Title
Eligibility of a novel BW + technology and comparison of sensitivity and specificity of different imaging methods for radiological caries detection
Authors
Kathrin Becker
Henrike Ehrlich
Mira Hüfner
Nicole Rauch
Caroline Busch
Beryl Schwarz-Herzke
Dieter Drescher
Jürgen Becker
Publication date
29-04-2024
Publisher
Springer Nature Singapore
Keyword
Caries
Published in
Oral Radiology
Print ISSN: 0911-6028
Electronic ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-024-00748-4