Reprodutibilidade Diagnóstica das Imagens Radiográficas Convencional e Digitais da Cárie Dentária
Diagnostic reproducibility of conventional and digital radiographic images of dental caries
Tosoni, G.M.; Capelozza, A.L.A.; Loffredo, L.C.M.; Miyahara, F.M.
Rev. odontol. UNESP, vol.33, n2, p.59-64, 2004
Resumo
O objetivo deste trabalho foi verificar a reprodutibilidade intra-examinador das imagens radiográficas convencional e digitais no diagnóstico de cáries proximais e oclusais. Dezesseis dentes, pré-molares e molares, foram montados em contato proximal e radiografados utilizando-se filmes convencionais (EP21) e a placa de armazenamento de fósforo do Sistema Digital Digora. As imagens convencionais também foram digitalizadas em um escaner de mesa. Um observador, treinado e calibrado, interpretou as imagens convencionais e as digitais nos modos normal e invertido, em um mesmo programa para manipulação da imagem. As superfícies dentárias oclusais e proximais foram classificadas utilizando-se escores de 0 a 5, os quais determinavam a presença e a extensão de lesão cariosa. Foi utilizada a estatística Kappa (κ) para verificar a reprodutibilidade intra-examinador das imagens radiográficas convencional e digitais. A imagem digital direta apresentou ótima reprodutibilidade nas superfícies proximais e oclusais, enquanto a imagem convencional apresentou boa reprodutibilidade. A reprodutibilidade da imagem digitalizada foi regular nas superfícies proximais e nas oclusais quando houve inversão da imagem. A reprodutibilidade da imagem digitalizada foi semelhante à da imagem convencional nas superfícies oclusais e nas proximais quando houve inversão da imagem. A inversão da imagem diminuiu a reprodutibilidade das imagens digitais direta e digitalizadas, com exceção da imagem digitalizada nas superfícies proximais. Concluiu-se que este estudo in vitro forneceu evidências de que a radiografia digital, associada aos recursos de captura e manipulação da imagem, pode influenciar favoravelmente ou não no diagnóstico de cárie. Acreditase que mais estudos são necessários no intuito de determinar qual recurso é mais eficaz.
Palavras-chave
Radiografia dentária, cárie dentária, radiografia dentária digital.
Abstract
The aim of this study was to verify the intraobserver reprododucibility of conventional and digital radiographic images on occlusal and approximal caries diagnoses. Radiographs of sixteen extracted human premolars and molars teeth were taken with conventional films (Kodak Ektaspeed Plus) and storage phosphor plate system (Digora). The films also were digitized in a flatbed scanner. One observer, trained and calibrated, read the conventional and digital images (direct and digitized) in normal and inverted mode in the same image processing software. A scale of five points scored the carious lesions. The intraobserver reproducibility of radiographic images was determined by Kappa statistics. The direct digital image presented optimum reproducibility in the approximal and occlusal surfaces, while the conventional image presented good reproducibility. The reproducibility of the digitized image was fair in the approximal surfaces, as well as in the occlusal surface, when the image was inverted. The reproducibility of digitized image was similar the conventional image in the occlusal surfaces and, in the approximal, when the image was inverted. The inversion of the image reduced reproducibility of the digitized and direct digital images, except for the digitized image in the aprroximal surfaces. We concluded that this in vitro study provided evidences that the digital radiography, associated to the resources of capture and image processing, can influence favorably or not the caries diagnosis. We believe that more studies are necessary in order to determine which resource is more effective.
Keywords
Radiography, dental, dental caries, radiography, dental, digital
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