The efficacy of a computerized caries detector in intraoral digital radiography.

BACKGROUND A unique software tool has been developed to assist dentists in the difficult task of diagnosing radiographs for proximal caries. The software, called Logicon Caries Detector (Northrop Grumman Information Technology, Herndon, Va.), extracts image features and correlates them with a database of known caries problems. The Logicon software was combined with the digital radiography system Trophy RadioVisioGraphy (Trophy Radiologie, Croissy-Beaubourg, France) and its effectiveness was measured in a clinical study, the results of which are reported here. METHODS The manufacturer trained 18 dentists in private practices and one university clinic across the United States to use the Logicon Caries Detector software. The dentists diagnosed 175 surfaces with potential caries and adjacent teeth expected to be clean but included as control surfaces. The dentists first did a visual diagnosis only and then repeated the diagnosis using the software. If their final diagnosis called for it, a restoration was performed and the depth of caries was recorded. RESULTS Effectiveness was gauged by calculating three measures of performance-sensitivity, specificity and accuracy-for dentin caries diagnosis by each dentist both before and after using Logicon Caries Detector. Sensitivity among all dentists before using the Logicon software was 70.3 percent and afterward was 90.5 percent, an improvement of 20.2 percent. Dentists' specificity was 88.6 percent before using the software and 88.3 percent afterward, with a difference of-0.3 percent. Dentists' accuracy was 75.6 percent before using the software and 88.3 percent afterward, with an improvement of 12.7 percent. CONCLUSIONS Logicon Caries Detector enabled dentists to find 20 percent more cases of caries penetrating into dentin than they were able to find without it, while not causing them to mistreat any additional healthy teeth. CLINICAL IMPLICATIONS Digital radiography and smart software like Logicon Caries Detector will improve dentists' diagnostic abilities and lead to better patient care.