J Am Dent Assoc. 2017 Oct 28. pii: S0002-8177(17)30788-2. doi: 10.1016/j.adaj.2017.08.032. [Epub ahead of print]
Abstract
BACKGROUND:
Extraoral
bite-wing (EB) radiography is an imaging technology used in dentistry.
The authors conducted an in vivo study comparing the accuracy of
intraoral bitewing (IB) radiographs and EB radiographs for proximal
caries and bone loss diagnosis.
METHODS:
The
authors recruited 116 patients who received IB radiographs to receive
EB radiographs. The 5 calibrated authors made a consensus radiographic
diagnosis of proximal caries and crestal bone loss. For this study, they
assumed IB radiographs as the criterion standard. Next, they obtained
EB radiographs for the 116 patients and calculated sensitivity,
specificity, and false-positive rates against each patient's IB
radiograph.
RESULTS:
The
patients' EB radiographs revealed a significantly greater number of
caries and crestal bone loss findings compared with their IB
radiographs. The EB radiographs had a high to excellent sensitivity and
moderate to low specificity of caries and crestal bone loss findings,
respectively. Considering IB radiographs to be the criterion standard,
the false-positive rate for EB radiographs was moderate for caries and
high for bone loss diagnosis.
CONCLUSIONS:
The
EB radiographs, which generate fewer images of overlapping proximal
surfaces, have the advantage of detecting more carious lesions and bone
loss findings than the IB radiographs do, but with the disadvantage of
more false-positive diagnoses. Further research is needed to evaluate if
the false-positive findings represent true carious lesions and bone
loss.
PRACTICAL IMPLICATIONS:
EB
radiography is a promising technology, which has several advantages
over traditional IB radiography. Clinicians should be aware of
false-positive diagnosis of caries and bone loss with EB radiography.
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