Eligibility of a novel BW + technology and comparison of sensitivity and specificity of different imaging methods for radiological caries detection

Objectives Bitewing radiography is considered to be of high diagnostic value in caries detection, but owing to projections, lesions may remain undetected. The novel bitewing plus (BW +) technology enables scrolling through radiographs in different directions and angles. The present study aimed at co...

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Bibliographic Details
Published in:	Oral radiology Vol. 40; no. 3; pp. 424 - 435
Main Authors:	Becker, Kathrin, Ehrlich, Henrike, Hüfner, Mira, Rauch, Nicole, Busch, Caroline, Schwarz-Herzke, Beryl, Drescher, Dieter, Becker, Jürgen
Format:	Journal Article
Language:	English
Published:	Singapore Springer Nature Singapore 2024 Springer Nature B.V
Subjects:	Cadaver Cadavers Cone-Beam Computed Tomography Demineralization Dental caries Dental Caries - diagnostic imaging Dental enamel Dentistry Humans Imaging Imaging, Three-Dimensional Lesions Medicine Oral and Maxillofacial Surgery Original Original Article Radiography Radiography, Bitewing Radiology Reproducibility of Results Sensitivity and Specificity Teeth 3D-Radiology Dental radiography Dental caries Digital imaging Effective dose Cone Beam CT
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Summary:	Objectives Bitewing radiography is considered to be of high diagnostic value in caries detection, but owing to projections, lesions may remain undetected. The novel bitewing plus (BW +) technology enables scrolling through radiographs in different directions and angles. The present study aimed at comparing BW + with other 2D and 3D imaging methods in terms of sensitivity, specificity, and user reliability. Materials and methods Five human cadavers were used in this study. In three cadavers, natural teeth were transplanted post-mortem. BW + , two-dimensional (digital sensors, imaging plates, 2D and 3D bitewing radiographs) and 3D methods (high and low dose CBCT) were taken. Carious lesions were evaluated on 96 teeth at three positions (mesial, distal, and occlusal) and scored according to their level of demineralization by ten observers, resulting in 35,799 possible lesions across all observers and settings. For reference, µCT scans of all teeth were performed. Results Overall, radiographic evaluations showed a high rate of false-negative diagnoses, with around 70% of lesions remaining undetected, especially enamel lesions. BW + showed the highest sensitivity for dentinal caries and had comparatively high specificity overall. Conclusions Within the limits of the study, BW + showed great potential for added diagnostic value, especially for dentinal caries. However, the tradeoff of diagnostic benefit and radiation exposure must be considered according to each patient’s age and risk.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0911-6028 1613-9674 1613-9674
DOI:	10.1007/s11282-024-00748-4