Comparison of accuracy and examiner reliability in evaluation of extent of proximal caries on digital bitewing and digital opg

Objectives: The purpose of this study was to assess examiner or observer reliability and to correlate the diagnostic accuracy of proximal caries detection by digital bitewing and panoramic radiographic images. Methods: In this study, digital bitewing and panoramic radiographs of 168 subjects were used. The radiographs were evaluated for the depth of proximal caries by two examiners. Diagnostic accuracy of two modalities was analyzed by means of percentage agreement and discrepancy index. Examiners reliability was assessed using Kappa statistics and Chi Square test. Results: Digital bitewing radiographs were more efficient in diagnosis of dental caries involving enamel and outer third of dentin. However, digital panoramic radiography had comparable accuracy with bitewing radiographs when lesion involved inner portions of dentin. Conclusion: Panoramic survey alone was not sufficient for the diagnosis of proximal caries of the entire dentition, but it showed significant diagnostic value in the detection of dentinal carious lesions. Hence, panoramic radiography can be endorsed for detection of proximal carious lesions with moderate to advanced tooth structure loss.