Observers Agreement in Perception of Non-Cavitated Approximal Dental Caries by Intraoral Digital CCD Radiography at Different Exposure Parameters and Corresponding Required Radiation Dose

Mohamed Mehanny, Marcel Noujeim
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Abstract

Objectives: To evaluate the diagnostic accuracy of Charged Coupled device (CCD) in detection of Non- Cavitated Approximal caries at different exposure parameters in relation to radiation dose in vitro. Study Design: Seventy-eight surfaces of extracted teeth were inserted in acid gel to create non-cavitated proximal caries with different depth, and then Radiographs have been taken to all teeth by CCD sensor. Radiographs were interpreted by three observers. The lesions were classified as (N) No lesion, (D1) Less than ½ enamel thickness, (D2) more than halfway of enamel but not involve DEJ. (D3) Dentin caries. Teeth were randomly selected for histological analysis after consensus from three oral and maxillofacial radiologists as Gold standard. The corresponding radiation dose was measured by unfors meter device at different exposure parameters. Results: The histological examination showed that the distribution of lesions was 39.8% Sound, both enamel lesions are equal 17.8%, Dentin lesions 24.6. The sensitivity and specificity of CCD to detect normal surfaces were 0.95, D1 was 0.37, D2 was 0.74 and D3 was 0.86. As the lesions depth increased, the sensitivity increased. The higher image quality was produced by using exposure parameters (70 KvP, 160 ms) and (70 KvP, 200 ms). While, (60 KvP, 200 ms) and (60 KvP, 250 ms) produced the worse image quality. Conclusion: Regard the balance between the higher diagnostic accuracy of digital images and minimum radiation dose: using exposure parameters as (70 KvP, 160 ms) is considered the best image quality and relative dose (81 mSv). While, (70 KvP, 125ms) and (66 KvP, 160 ms) are little bit lower quality and corresponding dose are (63), (73) respectively. Although (70 KvP, 200 ET) produce higher image quality but its relative dose is high (101mSv).
不同照射参数及所需辐射剂量下口内数字CCD成像对非空化近似龋的感知一致
目的:评价电荷耦合器件(CCD)在不同暴露参数下检测非空化近似龋的诊断准确性与体外辐射剂量的关系。研究设计:将拔牙的78个表面插入酸性凝胶中,形成不同深度的无空蚀近端龋,然后通过CCD传感器对所有牙齿拍摄x线片。x光片由三个观察者解读。病变分为(N)无病变,(D1)牙釉质厚度小于1 / 2,(D2)牙釉质厚度大于一半,但不涉及DEJ。(D3)牙本质龋齿。经三名口腔颌面放射科医师一致同意后,随机选择牙齿进行组织学分析作为金标准。在不同的照射参数下,用unfors计量仪测量相应的辐射剂量。结果:组织学检查显示病变分布为39.8%,两种牙釉质病变均为17.8%,牙本质病变为24.6%。CCD检测法向表面的灵敏度和特异性分别为0.95,D1为0.37,D2为0.74,D3为0.86。随着病变深度的增加,敏感性增加。使用曝光参数(70 KvP, 160 ms)和(70 KvP, 200 ms)可以获得更高的图像质量。而(60KvP, 200 ms)和(60KvP, 250 ms)产生的图像质量较差。结论:将数字影像较高的诊断准确率与最小辐射剂量相权衡,以(70 KvP, 160 ms)照射参数为最佳图像质量,相对剂量为81 mSv。(70KvP, 125ms)和(66 KvP, 160 ms)质量稍低,相应剂量分别为(63)、(73)。虽然(70 KvP, 200 ET)产生较高的图像质量,但其相对剂量高(101mSv)。
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