Comparative evaluation of the diagnostic efficacy of conventional film radiography and direct digital radiography for detection of periapical lesions

Purpose: The study evaluated the accuracy of diagnosing periapical lesions through conventional radiography (CR) and digital radiography (DR) technique.
Material and methods: 250 patients (125 with tenderness and 125 without tenderness) in the age range of 20-39 yrs with clinically suspected periapical pathosis and 50 normal subjects as control were included in the study. Both the conventional and digital images were taken with same exposure parameters keeping the film without lead foil and sensor simultaneously, to standardize the images. One endodontist and two oral radiologists evaluated all conventional and digital images and gave their final diagnosis for each technique separately. The diagnostic accuracy of each observer and image mode was calculated as the areas under receiver operating characteristic (ROC) curves. The mean values were statistically compared with the Wilcoxon’s signed rank test.
Results: The intraobserver variation and interobserver variation were high with conventional radiographic technique in diagnosing initial periapical lesions. The difference between the conventional radiography and digital radiography in accurately diagnosing periapical lesion was non-significant.
Conclusion: Conventional radiography has more diagnostic value as compared to digital radiography in diagnosing periapical lesions and hence, can be employed in routine practice owing to its advantages over conventional one.