目的:Bitewing射线照相被认为在龋齿检测中具有很高的诊断价值,但是由于预测,病变可能未被发现。新颖的bitewingplus(BW)技术可在不同方向和角度的射线照片中滚动。本研究旨在将BW+与其他2D和3D成像方法在灵敏度方面进行比较,特异性,用户可靠性。
方法:本研究中使用了五具人类尸体。在三具尸体中,自然牙齿在死后移植。BW+,二维(数字传感器,成像板,采取2D和3DbitewingX光片)和3D方法(高剂量和低剂量CBCT)。在三个位置(mesial,远端,和咬合),并由十名观察者根据其脱矿质水平进行评分,在所有观察者和环境中导致35,799个可能的病变。供参考,对所有牙齿进行μCT扫描。
结果:总体而言,影像学评估显示假阴性诊断率很高,大约70%的病变仍未被发现,尤其是牙釉质损伤.BW对牙本质龋表现出最高的敏感性,并且总体上具有相对较高的特异性。
结论:在研究范围内,BW+显示出巨大的增加诊断价值的潜力,尤其是牙本质龋齿.然而,诊断获益和辐射暴露的权衡必须根据每个患者的年龄和风险来考虑。
OBJECTIVE: 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.
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.