Comparison of Dexis CariVu to Traditional Bitewing Radiography for Diagnosis of Interproximal Caries

Purpose: To evaluate the accuracy, sensitivity, specificity, and inter-rater reliability of the DEXIS CariVu device in detecting interproximal carious lesions compared to digital radiography. Methods: Digital bitewing radiographs and CariVu images of the same interproximal surfaces were obtained. An expert committee comprised of two faculty members at the University of Illinois College of Dentistry, Department of Pediatric Dentistry, agreed upon 90 images. A questionnaire comprised of a blinded pairing of radiographic and CariVu images was distributed to 24 residents and faculty members. Raters scored both sets of images for depth of the carious lesion on the same scoring system as the expert committee. Results: The accuracy was 84% for bitewings and 50% for CariVu. Sensitivity and specificity ranges were 0.92-0.99 and 0.87-0.93 for bitewings and 0.68-0.82 and 0.53-0.72 for CariVu. There was no difference in inter-rater reliability for either bitewings or CariVu by rater status. There was a difference in inter-rater reliability between bitewings and CariVu, with bitewings being more accurate. Conclusions: Carivu has low accuracy for detecting caries. For the incipient caries images, there was a nearly even divide between under-scoring and over-scoring. Increased training to improve both capturing and interpreting CariVu images may at least partially improve the accuracy. At this time, CariVu may be used as an adjunct method to help verify caries detected by bitewings.