Benn, Douglas Keith; (1991) An evaluation of computer-based radiographic methods in estimating dental caries and periodontal diseases. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Reductions in dental diseases have resulted in a need for more accurate diagnostic and monitoring methods. The purpose of this study was to 1) identify the best diagnostic technique, 2) investigate the main factors which limit its validity and reliabilty and 3) devise methods to improve its reliability and 4) investigate ways of automating its use for general dental practice. From the literature review radiography was identified as the best current method with regard to validity, reliability, production of stable objective data and ease of use. However, irradiation geometry variations between serial films and subjective measurement errors were its principle limitations. Although an accurate semi-automatic caries measuring system exists, it is unsuitable for general practice due to lengthy operator interaction. A series of computer-based experiments were devised to evaluate further the digital subtraction radiography technique (DSR); develop a new method using stored regions of interest (ROI) to reduce subjective measurement errors; investigate the feasibility of completely automatic image analysis. In addition, an in vitro caries experiment was designed to demonstrate the effects of irradiation geometry variation on lesion size and caries scores. The results demonstrated that small variations in irradiation geometry can change radiographic scores. Misalignment of subsequent films beneath a video camera can cause significant errors in the DSR technique. The stored ROI method reduced cement-enamel junction to alveolar crest measurement errors to standard deviation 0.15mm. A fully automatic method for recognising teeth and bone crests was demonstrated. It was concluded that 1) radiography is currently the technique of choice, 2) a new significant methodological error for DSR has been demonstrated, 3) the subjective ROI method produced lower intra- and inter-examiner measurement errors compared to similar methods, 4) routine use of automatic methods may be feasible and should be investigated further and 5) standardised irradiation geometry is essential.

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