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How does triangular-shaped radiolucency affect caries diagnosis?

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Abstract

Objectives

Dental radiographs provide valuable information for dentists. However, during radiographic evaluation, dental practitioners may come across radiolucent shadows that closely mimic carious lesions and lead to false-positive diagnoses. Among these is triangular-shaped radiolucency (TSR), which can occur on the mesial surface of maxillary deciduous and permanent molars and arises from their anatomic structures. Because of its resemblance to dentinal caries, this study aimed to evaluate dental practitioners’ knowledge of TSR and the effect of clinical experience on TSR diagnosis.

Methods

Ninety-four observers (47 final-semester dental students and 47 dentists with >4 years of clinical experience) evaluated four digital images of 11 extracted human teeth (nine deciduous molars and two first permanent maxillary molars), among which six proximal surfaces showed TSR. Histologic sectioning was used as the gold standard for differentiating between caries and TSR. Two oral and maxillofacial radiologists defined TSRs with agreement. Custom-made software was used for image display.

Results

Overall, 20 ± 9.34 % of observers mistakenly diagnosed TSR as a carious surface, 79.37 ± 10.53 % diagnosed it as a sound surface or Mach band effect, and only a few observers (0.53 ± 1.31 %) correctly diagnosed it as TSR. There was no significant difference between students and dentists for number of caries misdiagnoses of TSR (P = 0.859).

Conclusions

Dental practitioners and students have hardly any knowledge about TSR, leading to a considerable rate of false-positive caries diagnosis. It is highly likely that training dental practitioners in this phenomenon will improve their diagnostic performance and subsequent treatment plans.

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Acknowledgments

The authors thank the Vice-Chancellery of Research, International Branch of Shiraz University of Medical Science, for supporting this research (Grant No. 8692052). This manuscript has been extracted from Dr. Hanye Sadat Tavakoli’s DDS thesis, which was conducted under the supervision of Dr. Najmeh Movahhedian and advisement of Dr. Sadaf Adibi. The authors would like to express their gratitude to Dr. Mehrdad Vossoughi of the Center for Research Improvement of the School of Dentistry for the statistical analysis and Dr. Leila Khojastepour for excellent advice and help throughout this project. We also thank Dr. Ehya Amalsaleh for improving the use of English in the manuscript.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shiraz University of Medical Sciences, Ghasroddasht Street, Ghomabad Ave, Shiraz, Iran

    Najmeh Movahhedian & Sadaf Adibi

  2. Student Research Committee, School of Dentistry, International Branch, Shiraz University of Medical Sciences, Nader Kazemi Clinic, Valiasr Square, Shiraz, Iran

    Hanie Sadat Tavakoli

  3. Department of Computer Engineering, Faculty of Engineering, Arak University, Arak University Sardasht Campus, Arak, Iran

    Hasan Baseri

Authors
  1. Najmeh Movahhedian
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  2. Sadaf Adibi
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  3. Hanie Sadat Tavakoli
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  4. Hasan Baseri
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Correspondence to Sadaf Adibi.

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Conflict of interest

Najmeh Movahhedian, Sadaf Adibi, Hanie Sadat Tavakoli, and Hasan Baseri declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Movahhedian, N., Adibi, S., Tavakoli, H.S. et al. How does triangular-shaped radiolucency affect caries diagnosis?. Oral Radiol 33, 32–37 (2017). https://doi.org/10.1007/s11282-016-0243-y

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  • DOI: https://doi.org/10.1007/s11282-016-0243-y

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