Diagnostic accuracy of conventional and digital radiography for detecting misfit between the tooth and restoration in metal-restored teeth
Volume 113, Issue 1, January 2015, Pages 39–47
Abstract
Statement of problem
Although
the postprocessing of digital images with enhancement filters could
lead to the presence of artifacts and result in false-positive
diagnoses, no study has analyzed whether the use of digital radiographs
and/or postprocessing of digital images interferes with the diagnosis of
marginal adaptation in metal-restored teeth.
Purpose
The
purpose of this study was to compare the diagnostic accuracy of
conventional and digital radiographic images with and without filters
for detecting a misfit between the tooth and restoration in
metal-restored teeth.
Material and methods
Forty
teeth with mesial-occlusal-distal inlays and 40 with complete crowns
(each with a perfect fit, 20 with a 0.2-mm gap and 20 with a 0.4-mm gap)
were imaged with conventional film and digital phosphor plate
systems. Digital radiographs were exported as original images and with
edge enhancement (high and low), inversion, and pseudo-3-dimensional
filters. Four examiners assessed the presence of gaps by using a
categorical scale (fit, misfit, cannot decide). Sensitivity,
specificity, and overall accuracy were calculated for each variable. In
addition, time spent scoring the images was recorded. A multivariate
logistic regression was performed with accuracy as the dependent
variable.
Results
Of the
images, 6.2% received the score “cannot decide,” most of them with a
high edge enhancement filter and in the crown group. A tendency for
higher sensitivity (range 0.67-0.83), specificity (range 0.81-0.92), and
accuracy (range 0.73-0.86) values was found in conventional and digital
original images. Results of a logistic regression found that
restoration type, gap size, and high enhancement and inversion filters
had a statistically significant impact on accuracy (P<.05).
Conclusions
Original
nonfiltered images should be used to assess teeth with metal
restorations. High enhancement filters and image inversion should be
avoided, especially when metal crowns are present.
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