The Value of Periapical Radiograph in the Diagnosis of Interproximal Caries

Kim, Young Hee; Kang, Byung Cheol

Abstract

PURPOSE: To compare the diagnostic performance of clinical and radiologic examination for the interproximal caries on intraoral periapical radiographs and to evaluate the value of periapical radiographs.
METHODS
One hundred seven dental patients were examined clinically, with a mouth mirror and an explorer, by a dentist at the department of oral medicine, and the presence or absence of interproximal caries lesion was recorded. The patients were prescribed one or more dental periapical radiographs. Radiographs were assessed for the presence of interproximal caries by three radiologists independantly. Two thousand sixty interproximal surfaces were included in this study. The diagnostic accuracies of clinical and radiologic examinations for interproximal caries were calculated. To assess the degree of agreement between clinical and radiologic examinations, Cohen's coefficient of agreement was computed.
RESULTS
The specificity of clinical and radiologic examination was 0.991, 0.997 and the sensitivity was 0.279, 0.985 respectively. The diagnostic accuracy of radiologic examination was statistically significantly higher than that of clinical examination(P<0.05). Cohen's kappa value of clinical and radiologic examination was 0.335, 0.942 respectively. These results suggested that clinical examination show only fair agreement, whereas radiologic examination show perfect agreement.
CONCLUSION
The diagnositic performance of the dental periapical radiographs on interproximal caries were higher than that of clinical examination, thus this study showed the validity of periapical radiographs for detecting interproximal caries lesion without bitewing radiograph.