Arayüz çürüklerinin saptanmasında beş farklı tekniğin diagnostik doğruluğu

Yıl 2018, Cilt: 35 Sayı: 1, 9 - 16, 12.09.2017

Defne Yalçın Yeler , Melike Koraltan

https://doi.org/10.17214/gaziaot.294870

Cited By: 1

Öz

Amaç: Bu çalışmanın amacı, beş farklı radyografik
görüntüleme yönteminin posterior dişlerde arayüz çürük teşhisindeki doğruluk
değerlerinin karşılaştırılmasıdır.

Gereç ve Yöntem: Çalışmada çürüklü ve
çürüksüz 72 adet posterior diş kullanıldı. Geleneksel bitewing radyograflar
intraoral film kullanılarak, dijital bitewing radyograflar ise fosfor plak
sistem kullanılarak alındı. Panoramik görüntüler dijital panoramik cihazın
bitewing, ortogonal ve standart programları kullanılarak elde edildi. Görüntüler
iki gözlemci tarafından değerlendirildi. Gözlemci içi ve gözlemciler arası uyum
ağırlıklandırılmış kappa katsayısı hesaplanarak belirlendi. Çürük tespitinde
altın standart kabul edilen histopatolojik skorlar ile beş yöntemden elde
edilen skorlara ROC analizi uygulandı. Yöntemlere ait Az değerleri z-testi ile
karşılaştırıldı ve anlamlılık düzeyi 0.05 olarak kabul edildi. Yöntemlere ait
sensitivite, spesifisite ve yanlış pozitif oranları hesaplandı.

Bulgular: Gözlemci içi ve gözlemciler arası uyuma ait κ değerleri sırasıyla 0.59-0.88 ve 0.54-0.87 arasında
değişti. ROC analizinde ortalama Az değerleri en yüksek olarak geleneksel
bitewing yönteminde (0.760) ve fosfor plak sisteminde (0.756), en düşük olarak ise
panoramik cihazın standart programında (0.639) bulundu. Standart panoramik
görüntüler çürük teşhisinde diğer yöntemlerden anlamlı olarak yetersiz bulundu
(p<0.05). Yöntemlerin sensitivite ve spesifisite değerleri sırasıyla;
geleneksel yöntem için 0.64-0.85, fosfor plak için 0.64-0.87, standart program
için 0.40-0.87, ortogonal program için 0.56-0.85, ekstraoral bitewing için
0.59-0.90 olarak bulundu.

Sonuç: Çalışmada geleneksel bitewing ve fosfor plak
bitewing görüntüleri benzer doğruluk düzeyine sahip bulundu. Panoramik
cihazdaki ortogonal ve bite-wing programların süperpozisyonların azaltılmasında
etkili olduğu gözlendi. Yöntemlerin mine çürüğü düzeyinde sensitiviteleri düşük
bulgulandı.

Anahtar Kelimeler

Isırtma radyografisi, panoramik radyografi, diş çürükleri

Diagnostic accuracy of five different techniques for detection of approximal caries

Öz

Objective: The aim of this study was to compare the accuracy of
five different radiographic methods for the detection of approximal caries on
posterior teeth.

Materials
and Method: Seventy-two extracted posterior
teeth with and without caries were studied. Intraoral bitewing radiographs were
taken with film and a storage phosphor-plate system. Extraoral panoramic images
were obtained by using the bitewing, orthogonal and standard programs of a
digital panoramic radiography device. Images were evaluated by two observers.
Intra- and inter-observer weighted-kappa coefficients were calculated. Scores
obtained from the five techniques were compared against the histological gold
standard using receiver operating characteristics (ROC) curve analysis. Az
values for each image type were compared using z-test and the level of
statistical significance was set at 0.05. Sensitivity, specificity and
false-positive rates were calculated for each method.

Results: Intra- and inter-observer agreement κ values were between 0.59-0.88 and 0.54-0.87,
respectively. The Az value was greatest with conventional bitewing (0.760) and
phosphor plate bitewing (0.756) and lowest with standard panoramic image program
(0.639). The standard panoramic image program was significantly inferior to the
other diagnostic methods (p<0.05).
Sensitivity and specificity values were 0.64 and 0.85
for conventional bitewing, 0.64 and 0.87 for phosphor plate bitewing, 0.40 and
0.87 for standard program, 0.56 and 0.85 for orthogonal program, and 0.59 and
0.90 for extraoral bitewing program, respectively.

Conclusion: In this study, conventional and phosphor plate
bitewing images were found to confer similar diagnostic accuracy. Orthogonal
and extraoral bitewing programs on panoramic devices were effective for
reducing superimpositions. The diagnostic sensitivity of the studied methods
for approximal caries was found to be low at the level of enamel.

Anahtar Kelimeler

Bitewing radiography, panoramic radiography, dental caries

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