Effect of display monitor devices on intra-oral radiographic caries diagnosis

Recent developments in digital computer technology have enabled radiological diagnosis to be performed using a monitor screen. In medical radiography, the importance of monitors has been shown in many diseases. Digital imaging and communication in medicine (DICOM)-compatible monitors are widely used. However, the effect of monitors on the diagnosis of oral disease has not yet been clarified and remains controversial. The aims of this study are to compare the caries diagnostic ability between DICOM monitors and other monitors and to examine if monitor capability affects the diagnosis.

One hundred proximal surfaces of 50 extracted human upper premolar teeth were used as specimens. Intra-oral radiographs of all specimens were taken digitally. Three types of monitors were compared in terms of caries diagnostic ability: a DICOM standard-compatible monitor, a standardized personal computer (PC) monitor, and a tablet PC. Six oral radiologists diagnosed each radiograph independently. Areas under the receiver operating characteristic (ROC) curve were generated and compared.

Area under the ROC curve (AUC) of the DICOM monitor, PC monitor, and tablet PC was 0.68147, 0.67002, and 0.60189, respectively. There was no significant difference between the DICOM monitor and the PC monitor, but the tablet PC showed significantly lower accuracy. There were no significant differences among the monitors for dentin caries (p > 0.05).

DICOM-compatible monitors and PC monitors have similar capabilities, but tablet PCs showed lower diagnostic accuracy, especially for superficial caries.

Appropriate monitors are needed for radiographic diagnosis on monitor screens.