Comparing the Accuracy in Diagnosing Periapical Lesions by Conventional and Direct Digital Radiography

This study investigated the accuracy of diagnosing periapical lesions through conventional radiography (CR) and direct digital radiography (DDR) technique. A total of 170 patients with clinically suspected periapical pathosis and 30 normal subjects were included in the study. Both the conventional and digital images were taken with same exposure parameters keeping the film without lead foil and sensor simultaneously, to standardize the images. One endodontist and two oral radiologists evaluated all conventional and digital images and gave their final diagnosis for each technique separately. The diagnostic accuracy of each observer and image mode was calculated as the areas under receiver operating characteristic (ROC) curves. The mean values were statistically compared with the Wilcoxon’s signed rank test. In results, the intraobserver variation and interobserver variation were high with conventional radiographic technique in diagnosing initial periapical lesions. There was a slight increase in the mean values for digital technique and in the accuracy of diagnosing the periapical lesions but using wilcoxon signed rank test the z-value was 1.367 and p-value was 0.172. The results of this study suggest that for the diagnosis of initial periradicular pathosis, the difference between the conventional and Trophy RVG 5000 DDR systems is insignificant. However, some advantages like elimination of chemical processing, immediate observation of radiographic images, ability to enhance images, and data storage make DDR preferable in comparison with CR for diagnosis of initial periapical lesions.