CLINICAL COMPARISON OF 2 PANORAMIC MODALITIES AND POSTERIOR BITE-WINGRADIOGRAPHY IN THE DETECTION OF PROXIMAL DENTAL-CARIES

A clinical study was designed to examine whether the Philips OrthOrali x SD (Gendex Dental Systems, Monza, Italy) orthogonal panoramic projec tion could improve diagnostic accuracy over standard projections in th e detection of proximal surface caries. Thirty-five sets of radiograph s that demonstrated optimal image characteristics were selected. Using a five-point scale, 18 viewers evaluated whether specified lesions we re present or absent. Viewer data was then compared with a consensus r adiographic assessment of the state of the proximal areas. Receiver op erating characteristic curves were generated with the use of a maximum -likelihood method of fit. The area under the receiver operating chara cteristic curve was used as the index of diagnostic accuracy. The mean receiver operating characteristic areas for orthogonal and standard p rojection panoramic and bite-wing radiography to detect the presence o f proximal dental caries were 0.68 +/- 0.03, 0.69 +/- 0.03, and 0.79 /- 0.03 respectively. Critical ratio analysis was used to compare the means for all possible pairings of imaging modalities. In overall perf ormance, conventional bite-wing radiographs gave a significantly great er diagnostic yield for proximal caries than the Philips OrthOralix SD orthogonal or standard panoramic modalities (p > 0.05). The orthogona l projection did not improve diagnostic accuracy in the detection of p roximal carious lesions compared with the standard projection.