Quantitative radiographic measurement of dentinal lesions

The purpose of this investigation was the comparison of the precision and accuracy of two reference ramp techniques for the quantification of radiographic density changes in teeth. Radiographs (65 kVp, 10 ma, 1 s, and intra-oral ultraspeed film) of transverse sections from extracted permanent human molars were made before and after dentinal lesions were created. Each radiograph contained the image of a tooth section and the aluminum reference ramp. Method A used the image of the ramp on both the before- and after-lesion radiographs, and method B used the image of the ramp only on the before-lesion radiograph. Three groups of lesions (0.525-mm diameter, n = 11; 0.675-mm diameter, n = 9; and the 0.525-mm holes enlarged to 0.675 mm) were measured radiographically by each technique and by direct planimetry of the lesions. Radiographic method B produced results in close agreement with the planimetric measurements. Method B differentiated (p less than 0.05) between groups that had a mean planimetric size difference of 0.10 mm (equivalent to a change in density difference of 0.6%). These density change measurements are in absolute units of mm of aluminum that can be compared between lesions and between samples. This technique may prove useful for the quantification of changes in mineral density of caries lesions detectable in longitudinal radiographic records.