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Title Digital Radiography And Film Radiography Are Similar In Accuracy Of Detection Of Dental caries
Clinical Question How does digital dental radiography compare in terms of diagnostic accuracy to conventional film dental radiography in detecting dental caries?
Clinical Bottom Line Digital radiography and film radiography are similar in sensitivity and specificity for detection of dental caries.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16940477 Wenzel/2006 Human subjects and human lab specimens Systematic Review
Key resultsNine of the studies compared one or more digital receptors with film and most of them showed that digital receptors provided accuracy for proximal and occlusal caries detection, which was not significantly different than film.
#2) 12474624 Bader/2002 Human subjects and human lab specimens Systematic Review
Key resultsThe pattern of results for digital methods was similar to that for film based methods, with consistently high specificities accompanied by a wide range of sensitivities.
#3) 20654681 Mitropoulos/2010 20 extracted human teethComparative Study
Key resultsSimilar diagnostic properties were found for conventional radiography (sensitivity 0.46-0.5; specificity 0.93 – 1.0) and digital radiography (sensitivity 0.46-0.5; specificity 0.94 – 1.0). Radiographic detection had lower sensitivity and higher specificity than visual examination with ICDAS II criteria.
Evidence Search ("Dental Caries"[Mesh]) AND "Radiography, Dental"[Mesh] and (Diagnosis/Narrow[filter]) AND (systematic[sb])(("Dental Caries/radiography"[Mesh]) AND "Radiography, Dental, Digital"[Mesh] AND (Diagnosis/Narrow[filter]) AND ("2006/01/01"[PDAT] : "2011/06/01"[PDAT]))
Comments on
The Evidence
Bader’s systematic review included 69 assessments of radiographic methods for detection of carious lesions, using histologic gold standard. Authors stated that the strength of evidence for stable evidence of performance was rated as poor for all applications due to the extensive variation in sensitivity among studies. Mitropoulos reported on two examiners evaluating caries on extracted teeth using film and CCD radiography, with histological examination as a gold standard.Wenzel’s review included 9 questionnaire studies, 5 clinical studies, and 28 laboratory studies.
Applicability The inclusion of a wide range of clinical studies and studies on human laboratory samples suggests that the results should be widely applicable.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Dental film radiography, Dental caries, Dental digital radiography
ID# 2077
Date of submission: 07/08/2011spacer
E-mail samuelt@livemail.uthscsa.edu
Author Tom A. Samuel
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by nestor olague (san antonio, TX) on 11/30/2017
A new search was conducted on this clinical question in November 2017, and no new evidence was located that provided a more conclusive answer. PMID #27681391 is a systematic review that assessed the diagnostic accuracy of digital radiograph and conventional radiography for proximal caries in primary teeth. Of 129 articles retrieved, only 4 articles were included and all studies were done in vitro. It was concluded that more higher quality studies are needed utilizing a randomized sample to determine if digital or conventional film is more accurate. A Trip Database search using PICO produced an evidence-based synopsis (Digital Radiography May Have Advantages Over Film Radiography, Gray S., 2011) suggesting that digital radiographs have other benefits such as reduced working time and radiation dose.

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