Diagnostic performance of approximal caries in bitewing radiographs from different monitors and room illuminances.

OBJECTIVE: To compare the accuracy, duration, and certainty of diagnosing approximal caries in bitewing radiographs displayed in 3 monitors under 2 luminance conditions. METHODS: A total of 39 teeth without evident caries were selected from 11 patients undergoing partial jaw resection. Before the operation, 13 bitewing radiographs were captured by a digital imaging system. Eight observers evaluated the images under dark (9 lux) and bright (200 lux) conditions, using 2 medical-grade monitors and a commercial monitor. Using histological results as the gold standard, the areas under the receiver operating characteristic curves under different conditions were compared using the Z-test. Multivariate analysis of variance was conducted to assess the impact of various factors on diagnostic duration, while ordinal logistic regression was used to examine factors influencing diagnostic certainty level. It was considered significant when P < .05. RESULTS: No significant difference was found in the diagnostic accuracy or duration for diagnosis of approximal caries under 2 luminance conditions with the 3 distinct monitors (P > .05). Ambient light, clinical experience, and the pathological grade of approximal caries have influence on the degree of diagnostic confidence (P < .05). CONCLUSIONS: Different monitors and ambient luminance didn't influence the diagnostic accuracy or evaluation duration. Ambient luminance, clinical experience, and the depth of caries affect the degree of diagnostic confidence. ADVANCES IN KNOWLEDGE: The study employing bitewing radiographs from real patients indicates that ambient luminance, clinical experience, and the depth of caries affect the degree of diagnostic confidence.