Ex Vivo Evaluation of New 2d and 3d Dental Imaging Technology for Detecting Caries

Proximal dental caries remains a prevalent disease with only modest detection rates by current diagnostic systems. X-ray radiography represents the most common and successful means of diagnosing early dental caries lesions, however; many new systems are available without controlled validation of diagnostic efficacy. This study evaluated the caries detection of three new dental radiographic imaging technologies: an intraoral digital detector employing an advanced sharpening filter, an extraoral " panoramic bitewing " imaging unit, and a cone beam-CT system with advanced artifact reduction. An ex vivo study design using extracted human teeth, expert observer ratings, and micro-CT ground truth analysis was employed. All modalities performed similarly in overall diagnostic accuracy yet differences were noted in selected system sensitivities and specificities. The CBCT system demonstrated the best assessment of lesion depth and lesion cavitation. Incorporating hydroxyapatite calibration phantoms allowed assessment of imaging consistency, linearity, and contrast resolution.