COMPARISON OF DIGITAL RADIOGRAPHIC METHODS FOR EARLY DETECTION OF INTERPROXIMAL CARIES IN YOUNG ADULTS: A CROSS-SECTIONAL STUDY

Abstract

Background: Early detection of interproximal enamel caries is a critical component of preventive dentistry, particularly in young adults where lesions often remain non-cavitated and clinically undetectable. Radiographic examination plays a central role in identifying these lesions; however, advances in digital imaging have introduced multiple radiographic techniques with varying diagnostic capabilities. Clear evidence comparing the diagnostic performance of these techniques for early enamel caries remains limited.

Objective: To compare the sensitivity and specificity of three digital radiographic techniques for the detection of early interproximal enamel caries in young adults.

Methods: A cross-sectional study was conducted among young adults attending dental clinics in an urban region. Standardized bitewing radiographs were obtained using direct digital sensor imaging, photostimulable phosphor plate imaging, and digitally enhanced radiography. Interproximal surfaces of posterior teeth were independently assessed by calibrated examiners blinded to clinical findings. Diagnostic outcomes were evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy. Statistical comparisons were performed using parametric tests, with significance set at p < 0.05.

Results: Early enamel caries were identified in 38.1% of the evaluated interproximal surfaces. Enhanced digital radiography demonstrated the highest sensitivity (81.4%) and overall diagnostic accuracy (79.8%). Direct digital sensor imaging showed moderate sensitivity (72.5%) and specificity (78.1%). Photostimulable phosphor plate imaging exhibited the highest specificity (82.4%) but lower sensitivity (65.3%). Differences in diagnostic performance among the three techniques were statistically significant.

Conclusion: Digital radiographic techniques differed significantly in their ability to detect early interproximal enamel caries. Enhanced digital radiography improved lesion detection, whereas PSP plate imaging minimized false-positive findings. These results support the informed selection of radiographic methods to optimize early caries diagnosis and preventive care.