Is the digital radiographic detection of approximal caries lesions influenced by viewing conditions?

Abstract

Objectives: The aim of this study was to assess the influence of different viewing conditions (combinations of computer display, horizontal viewing angle, and ambient lighting) on the detection of approximal caries lesions on digital radiographic images.

Study design: Forty posterior teeth were mounted in a plaster block and radiographed by using a CMOS sensor-based system. Three oral radiologists assessed the radiographic images under different conditions of computer display (iMac 5K 27", Barco MDRC-2124, and Dell P2314H), horizontal viewing angles (90 degrees, 67.5 degrees, and 45 degrees), and ambient lighting (low, medium, and high) and were asked to detect the presence of approximal caries lesions, which were confirmed by means of micro-computed tomography (micro-CT), using a 5-point scale. The area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared by analysis of variance testing (α = 0.05). Intra- and interobserver agreements were assessed with the Kappa test.

Results: Computer display, horizontal viewing angle, and ambient lighting did not significantly influence the diagnosis of approximal caries lesions. In general, moderate values of accuracy, low sensitivity, and high specificity were found for all viewing conditions.

Conclusions: The viewing conditions assessed in this study did not influence the detection of approximal caries lesions on digital radiographic images. Dental practitioners are encouraged to find their most comfortable viewing condition for this diagnostic task.