A comparison of diagnosis of early stage interproximal caries with bitewing radiographs and periapical images using consensus reference

The purpose of this study was to assess the diagnostic property of intraoral bitewing radiographs (BTW) for early stage interproximal caries, and to compare them with periapical radiographs (PA) at different levels of caries progression. A total of 241 interproximal surfaces of BTW and corresponding PAs were used. Seven teaching faculty consisting of three oral and maxillofacial radiologists, two operative faculty, and two prosthodontists evaluated the images. The observers graded images as either "intact", "enamel caries 1/2 width", or "caries into dentin". The gold-standard was established by consensus of two experienced faculty with 35 years and 27 years of experience. Specificity, sensitivity, positive-predictive value, and negative-predictive value were calculated for the different level of caries progression. Furthermore, receiver operating curves) of BTW and PAs of each evaluator were made and the area under the curve of BTW and PAs were compared. There was no significant difference in the specificity of BTW and PAs. BTW showed significantly higher sensitivity than PAs in all levels of caries progression (p