A Comparative Study of the Diagnostic Accuracy of Cone Beam Computed Tomography and Phosphor Storage Plate for Detection of Noncavitated Occlusal Caries

Abstract

© Wroclaw Medical University and Polish Dental Society. Background. Recent Studies have shown that a significant portion of occlusal caries could not be diagnosed in the early stages because of various reasons. Early detection of superficial caries is important for preventive dentistry. Objectives. This study aims to compare the quality of occlusal caries detection using digital phosphor storage plate (PSP) and cone beam computed tomography (CBCT). Material and Methods. For this experimental study 88 human molars were used. The clinical appearances of the occlusal surfaces of the teeth ranged from sound to discolor with no macroscopic cavitation. They were imaged using a digital system (PSP) and CBCT (NewTom 3G). Three independent observers assessed the images twice. ROC curve was used for assessment of the imaging systems accuracy for the detection of caries. A histological investigation was used as a gold standard. Methods were analyzed by ANOVA and t-test with p value of 0.05. Tests were performed with STATA software (version 11). Intra and inter observers agreement for each image set was assessed by ICC. Results. The average of observers results in caries detection with PSP images was 0.34 (P value = 0.208) and with CBCT images was equal to 0.45 (P value = 0.722). This showed that the diagnostic accuracy of CBCT and PSP was not acceptable compared with the gold standard. Although CBCT was a little higher than PSP on ROC curve, statistically there were no significant differences between both images in detecting occlusal caries. The ICC results showed acceptable agreement between observers in caries detection by CBCT and PSP, but the agreement between observers using these image modalities and the gold standard was poor. Conclusions. The accuracy of NewTom 3G CBCT for detecting occlusal caries was slightly better than PSP (not significantly), but none of them had the sufficient diagnostic accuracy for detecting incipient occlusal caries. Therefore, in these cases it is necessary to use other methods to improve detection.