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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.