Diagnostic accuracy of a charge-coupled device and a photostimulable phosphor plate in detection of non-cavitated proximal caries.

Ana Paola Trevejo-Bocanegra, Alejandro Hidalgo, Jorge Beltrán


Abstract: Objective: The aim of this study was to compare the diagnostic accuracy of two direct digital radiography systems: the charge-coupled device (CCD) XIOS XG Sirona® and the photostimulable storage phosphor (PSP) VistaScan DürrDental®, in the detection of non-cavitated proximal caries lesions. Materials and methods: in this experimental and cross-sectional study 112 proximal surfaces from 27 molars and 31 premolars with or without proximal caries lesions were evaluated and randomly allocated in a study unit. Bitewing radiographs were acquired with a CCD XIOS XG and with the PSP VistaScan. A single X-ray unit was used for both systems. Radiographic images were assessed independently by two calibrated radiologists. Histological evaluation on a stereomicroscope was used as gold standard. Results: Sensitivity values were found to be 0.35 for CCD and 0.31 for PSP. Specificity values were found to be similar for both systems (0.867). Az values showed a low diagnostic accuracy for both sensors: 0.61 for CCD and 0.59 for PSP, no statistical difference was found between these two values (p=0.78). Conclusion: Both digital radiology systems have a high diagnostic accuracy to detect sound surfaces but low diagnostic accuracy to detect proximal carious lesions.


sensitivity, specificity; dental radiography; dental caries.


Dehghani M, Barzegari R, Tabatabai H, Ghanea S. Diagnostic Value of Conventional and Digital Radiography for Detection of Cavitated and Non-Cavitated Proximal Caries. J Dent. 2017;14(1):21–30.

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation. 7th Ed. Canada: Mosby/Elsevier; 2014.

Isaacson KG, Thom AR, Atack NE, Horner K, Whaites E. Guidelines for the Use of Radiographs in Clinical Orthodontics. 4th Ed. London: British Orthodontic Society; 2015.

Kidd E, Fejerskov O. Changing concepts in cariology: forty years on. Dent Update. 2013;40(4):277–86.

Manton DJ. Diagnosis of the early carious lesion. Aust Dent J. 2013;58(Suppl 1):35–9.

Boeddinghaus R, Whyte A. Trends in maxillofacial imaging. Clin Radiol. 2018;73(1):4–18.

Abogazalah N, Ando M. Alternative methods to visual and radiographic examinations for approximal caries detection. J Oral Sci. 2017;59(3):315–22.

Senel B, Kamburoglu K, Uçok O, Yüksel SP, Ozen T, Avsever H. Diagnostic accuracy of different imaging modalities in detection of proximal caries. Dentomaxillofac Radiol. 2010;39(8):501–11.

Pontual AA, de Melo DP, de Almeida SM, Bóscolo FN, Haiter Neto F. Comparison of digital systems and conventional dental film for the detection of approximal enamel caries. Dentomaxillofac Radiol. 2010;39(7):431–6.

Li G, Berkhout WE, Sanderink GC, Martins M, van der Stelt PF. Detection of in vitro proximal caries in storage phosphor plate radiographs scanned with different resolutions. Dentomaxillofac Radiol. 2008;37(6):325–9.

Dikmen B. ICDAS II Criteria (International Caries Detection and Assessment System). J Istanb Univ Fac Dent. 2015;49(3):63–72.

Abesi F, Mirshekar A, Moudi E, Seyedmajidi M, Haghanifar S, Haghighat N, Bijani A. Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries. Iran J Radiol. 2012;9(1):17–21.

McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276–82.

Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285–93.

Abogazalah N, Eckert GJ, Ando M. In vitro performance of near infrared light transillumination at 780-nm and digital radiography for detection of non-cavitated approximal caries. J Dent. 2017;63:44–50.

Cooper L, Gale A, Darker I, Toms A, Saada J. Radiology image perception and observer performance: how does expertise and clinical information alter interpretation? Stroke detection explored through eye-tracking. 1a Ed. Argentina: Medical Imaging; 2009.

Ruiz de Adana R. Eficacia de una prueba diagnóstica: parámetros utilizados en el estudio de un test. JANO. 2009;1736:30–2.

Martins S, Álvarez E, Abanto J, Cabrera A, López RA, Masoli C, Echevarría SA, Mongelos MG, Guerra ME, Amado AR. Epidemiología de la caries dental en america latina. Rev Odontopediatr Latinoam. 2014;4(2):13–8.

Krzyżostaniak J, Kulczyk T, Czarnecka B, Surdacka A. A comparative study of the diagnostic accuracy of cone beam computed tomography and intraoral radiographic modalities for the detection of noncavitated caries. Clin Oral Investig. 2015;19(3):667–72.

Onem E, Baksi BG, Sen BH, Sögüt O, Mert A. Diagnostic accuracy of proximal enamel subsurface demineralization and its relationship with calcium loss and lesion depth. Dentomaxillofac Radiol. 2012;41(4):285–93.

Gomez J. Detection and diagnosis of the early caries lesion. BMC Oral Health. 2015;15(Suppl 1):S3.

Eli I, Weiss EI, Tzohar A, Littner MM, Gelernter I, Kaffe I. Interpretation of bitewing radiographs. Part 1. Evaluation of the presence of approximal lesions. J Dent. 1966;24(6):379–83.

Takahashi N, Nyvad B. Ecological Hypothesis of Dentin and Root Caries. Caries Res. 2016;50(4):422–31.

. Ferreira Zandoná A, Santiago E, Eckert GJ, Katz BP, Pereira de Oliveira S, Capin OR, Mau M, Zero DT. The natural history of dental caries lesions: a 4-year observational study. J Dent Res. 2012;91(9):841–6.

Gimenez T, Piovesan C, Braga MM, Raggio DP, Deery C, Ricketts DN, Ekstrand KR, Mendes FM. Visual Inspection for Caries Detection: A Systematic Review and Meta-analysis. J Dent Res. 2015;94(7):894–904.

Dulanto JA. Validación histológica in-vitro de ICDAS-II y MICRO-CT para la detección de lesiones de caries proximales y oclusales (Tesis) Madrid: Universidad Complutense de Madrid; 2015.

Freitas LA, Santos MT, Guaré RO, Lussi A, Diniz MB. Association Between Visual Inspection, Caries Activity Status, and Radiography with Treatment Decisions on Approximal Caries in Primary Molars. Pediatr Dent. 2016;38(2):140–7.

Hoskin ER, Keenan AV. Can we trust visual methods alone for detecting caries in teeth? Evid Based Dent. 2016;17(2):41–2.

Wenzel A. Radiographic display of carious lesions and cavitation in approximal surfaces: Advantages and drawbacks of conventional and advanced modalities. Acta Odontol Scand. 2014;72(4):251–64.

Kajan ZD, Tayefeh Davalloo R, Tavangar M, Valizade F. The effects of noise reduction, sharpening, enhancement, and image magnification on diagnostic accuracy of a photostimulable phosphor system in the detection of non-cavitated approximal dental caries. Imaging Sci Dent. 2015;45(2):81–7.

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