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
Referências
1. Arnold LV. The radiographic detection of initial carious lesions on the proximal surfaces of teeth. Part I. The influence of exposure conditions. Oral Surg Oral Med Oral Pathol. 1987; 64: 221-31.
2. Arnold LV. The radiographic detection of initial carious lesions on the proximal surfaces of teeth. Part II. The influence of viewing conditions. Oral Surg Oral Med Oral Pathol. 1987; 64: 232-40.
3. Dunn SM, Kantor ML. Digital radiology. Facts and fictions. J Am Dent Assoc. 1993; 124: 39-47.
4. Firestone AR, Lussi A, Weems RA, Heaven TJ. The effect of experience and training on the diagnosis of approximal coronal caries from bitewing radiographs. Schweiz Monatsschr Zahnmed. 1994; 104: 719-23.
5. Gotfredsen E, Wenzel A, Gröndahl H-G. Observers’ use of image enhacement in assessing caries in radiographs taken by four intra-oral digital systems. Dentomaxillofac Radiol. 1996; 25: 34-8.
6. Hollender L. Decision making in radiographic imaging. J Dent Educ. 1992; 56: 834-43.
7. Huda W, Rill LN, Benn DK, Pettigrew JC. Comparison of a photostimulate phosphor system with film for dental radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83: 725-31.
8. Huysmans MCDNJM, Hintze H, Wenzel A. Effect of exposure time on in vitro caries diagnosis using the Digora system. Eur J Oral Sci. 1997; 105: 15-20.
9. Kang B-C, Farman AG, Scarfe WC, Goldsmith LJ. Mechanical defects in dental enamel vs natural dental caries: observer differentiation using ektaspeed plus film. Caries Res. 1996; 30: 156-62.
10. Kang B-C, Farman AG, Scarfe WC, Goldsmith LJ. Observer differentiation of proximal enamel mechanical defects versus natural proximal dental caries with computed dental radiography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82: 459- 65.
11. Kashima I. Computed radiography with photostimulate phosphor in oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol. 1995; 80: 577-8.
12. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159-74.
13. Lazarchik DA, Firestone AR, Heaven TJ, Filler SJ, Lussi A. Radiographic evaluation of occlusal caries: effect of training and experience. Caries Res. 1995; 29: 355- 8.
14. Light RJ. Measures of response agreement for qualitative data: some generalizations and alternatives. Psychopharmacol Bull. 1971; 76: 365-77.
15. Lussi A. Impacting of including or excluding cavited lesions when evaluating methods for the diagnosis of occlusal caries. Caries Res. 1996; 30: 389-93.
16. Mileman PA, Van Der Weele LT. Accuracy in radiographic diagnosis: dutch practioners and dental caries. J Dent. 1990; 18: 130-6.
17. Møystad A, Svanaes DB, Larheim TA, Grondahl HG. Effect of image magnification of digitized bitewing radiographs on approximal caries detection: na in vitro study. Dentomaxillofac Radiol. 1995; 24: 255-9.
18. Møystad A, Svanaes DB, Risnes S, Larheim TA, Grondahl HG. Detection of approximal caries with a storage phosphor system. A comparison of enhanced digital images with dental x-ray film. Dentomaxillofac Radiol. 1996; 25: 202-6.
19. Ohki M, Okano T, Nakamura T. Factors determining the diagnostic accuracy of digitized conventional intraoral radiographs. Dentomaxillofac Radiol. 1994; 23: 77- 82.
20. Peers A, Hill FJ, Mitropoulos CM, Holloway PJ. Validity an reproducibility of clinical examination, fibre-optic transilumination, and bite-wing radiology for the diagnosis of small approximal carious lesions: an in vitro study. Caries Res. 1993; 27: 307-11.
21. Petrikowski CG, elBadrawy HE, Boehlau EE, Grace MG Interobserver variability in radiographic interpretation of pediatric dental diseases: a pilot study. J Can Dent Assoc. 1996; 62: 728-30.
22. Scaf G, Kantor ML, Walsh SJ. Effect of magnification on caries detection with RadioVisioGraphy (RVG) [abstract 1217]. J Dent Res. 1993; 72 (sp iss): 255.
23. Shrout MK, Russell CM, Polter BJ, Hildebolt CF. Spatial resolution in radiometric analysis of enamel loss. A pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 81: 245-50.
24. Svanaes DB, Moystad A, Risnes S, Larheim TA, Grondahl HG. Intra oral storage phosphor radiography for approximal caries detection and effect of image magnification. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82: 94-100.
25. Vandre RH, Webber RL. Future trends in dental radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 80: 471-8.
26. Verdonschot EH, Kuijpers JM, Polder BJ, De Leng Worm MH, Brorkhorst EM. Effects of digital grey-scale modification on the diagnosis of small approximal carious lesions. J Dent. 1992; 20: 44-9.
27. Verdonschot EH, Bronkhorst EM, Burgersdijk RC, Konig KG, Schaeken MJ, Truin GJ. Performance of some diagnostic systems in examinations for small occlusal carious lesions. Caries Res. 1992; 26: 59-64.
28. Versteeg CH, Sanderink GCH, Van Der Stelt PF. Efficacy of digital intra-oral radiography in clinical dentistry. J Dent. 1997; 25: 215-24.
29. Wenzel A. Digital radiography and caries diagnosis Dentomaxillofac Radiol. 1998; 27: 3-11.
30. Wenzel A, Fejerskov O. Validity of diagnosis of questionable caries lesions in occlusal surfaces of extracted third molars. Caries Res. 1992; 26: 188-94.
31. Wenzel A, Gröndahl H-G. Direct digital radiography in the dental office. Int Dent J. 1995; 45: 27-34.
32. Wenzel A, Hintze H. Perception of image quality in direct digital radiography after application of various image treatment filters for detectability of dental disease. Dentomaxillofac Radiol. 1993; 22: 131-4.
33. Wenzel A, Fejerskov O, Kidd E, Joyston Bechal S, Groeneveld A. Depth of occlusal caries assessed clinically, by conventional film radiographs, and by digitized, processed radiographs. Caries Res. 1990; 24: 327-33.
34. Wenzel A, Verdonschot EH, Truin GJ, Konig KG. Impact of the validator and the validation methods on the outcome of occlusal caries diagnosis. Caries Res. 1994; 28: 373-7.
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