Comparison of CBCT, CCD and PSP digital systems in the diagnosis of interproximal demineralized lesions

Digital radiography systems can be used to detect dental caries. These systems have the advantage of reducing patient dose. The purpose of this study was to compare digital photostimulable phosphor plate, charge coupled device and cone-beam computed tomography systems in detection of interproximal demineralization.

In this cross-sectional analytical laboratory study, sixty extracted human teeth with sound mesial and distal surfaces were selected. Using a ¼ round bur (0.5 mm in diameter) cavities were prepared to a depth of 0.25 mm just apical to the interproximal contact point on 15 surfaces of teeth. A ½ round bur (0.6 mm in diameter) was used to prepare cavities to a depth of 0.3 mm on 15 surfaces and a #1 round bur was used to prepare cavities 0.4 mm in depth on 15 surfaces. The teeth were mounted in groups of three in wax blocks. The images were captured by digital CBCT, PSP and CCD systems under a standard condition. One oral radiologist observed the images to detect interproximal defects twice three weeks apart. Then, sensitivity and specificity were calculated and Cochran test was used for statistical analysis with SPSS 20).α=0.05).

The sensitivity rates of CBCT, PSP and CCD systems for the detection of lesions measuring 0.25 mm in depth (incipient caries) were 100%, 93.3% and 86.7%, respectively (p value = 0.22); there was no differences between the systems in the detection of deeper lesions (100%). There was a high agreement rate between the radiographic systems evaluated and the gold standard in the detection of lesions with varying depths (CCD=94.4% and CBCT/PSP=100%). Specificity of all the systems was 100%.

Under the limitations of this study, there were no significant differences between CBCT, PSP and CCD digital radiographic systems in the detection of interproximal demineralization. The specificity of all the three systems was the same.