The aim of this study was to evaluate the accuracy on the diagnosis of secondary caries-like lesions simulated on esthetic restorations of different materials, changing the incidence vertical angle (IVA) of the x-ray beam. Twenty human teeth received MOD inlay preparations. In the experimental group (n=10), a round cavity was made in the floor of the proximal box to simulate the caries-like lesion. All teeth were restored with 3 composite resins (Charisma, Filtek-Z250 and TPH-Spectrum) at 3 moments. Two radiographic images were acquired with 0° and 10° IVA. Ten observers evaluated the images using a 5-point confidence scale. Intra- and interobserver reliability was analyzed with the Interclass Correlation Coefficient and the diagnostic accuracy was evaluated using the area under the ROC curve (Az), Friedman test and Wilcoxon test (α=0.05). Higher accuracy values were obtained with 10° IVA (Az=0.66, Filtek- Z250>Az=0.56, TPH-Spectrum) compared to 0° (Az=0.55, Charisma>Az=0.37, TPH-Spectrum), though without statistically significant difference (p>0.05). The detection of secondary caries-like lesions simulated on esthetic restorations of different materials suffered no negative influence by changing the IVA of the x-ray beam.222129133Levin, L., Coval, M., Geiger, S.B., Cross-sectional radiographic survey of amalgam and resin-based composite posterior restorations (2007) Quintessence Int, 38, pp. 511-514Haak, R., Wicht, M.J., Hellmich, M., Noack, M.J., Detection of marginal defects of composite restorations with conventional and digital radiographs (2002) Eur J Oral Sci, 110, pp. 282-286Kirkevang, L.L., Vaeth, M., Wenzel, A., Prevalence and incidence of caries lesions in relation to placement and replacement of fillings: A longitudinal observational radiographic study of an adult Danish population (2009) Caries Res, 43, pp. 286-293Newman, B., Seow, W.K., Kazoullis, S., Ford, D., Holcombe, T., Clinical detection of caries in the primary dentition with and without bitewing radiography (2009) Austr Dent J, 54, pp. 23-30Anbiaee, N., Mohassel, A.R., Imanimoghaddam, M., Moazzami, S.M., A comparison of the accuracy of digital and conventional radiography in the diagnosis of recurrent caries (2010) Contemp Dent Pract, 11, pp. 25-32Nair, M.K., Tyndall, D.A., Ludlow, J.B., May, K., Ye, F., The effects of restorative material and location on the detection of simulated recurrent caries. A comparison of dental film, direct digital radiography and tuned aperture computed tomography (1998) Dentomaxillofac Radiol, 27, pp. 80-84van der Stelt, P.F., Ruttiman, U.E., Webber, R.L., Heemstra, P., In vitro study into the influence from x-ray beam angulation on the detection of artificial caries defects on interproximal radiographs (1989) Caries Res, 23, pp. 334-341Tveit, A.B., Espelid, I., Erickson, R.L., Glasspoole, E.A., Vertical angulation from X-ray beam and radiographic diagnosis of secondary caries (1991) Community Dent Oral Epidemiol, 19, pp. 333-335Akarslan, Z.Z., Akdevelioǧlu, M., Güngör, K., Erten, H., A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximal caries detection in posterior teeth (2008) Dentomaxillofac Radiol, 37, pp. 458-463Sabbagh, J., Vreven, J., Leloup, G., Radiopacity of resin-based materials measured in film radiographs and storage phosphor plate (Digora) (2004) Oper Dent, 29, pp. 677-684Dental resin based restorative materials, 6 (10), pp. 1985-1985. , ISO:DP 4049, International standards organization (Draft Proposal), clauseMagalhães, C.S., Freitas, A.B., Moreira, A.N., Ferreira, E.F., Validity of staining and marginal ditching as criteria for diagnosis of secondary caries around occlusal amalgam restorations: An in vitro study (2009) Braz Dent J, 20, pp. 307-313Ergücü, Z., Türkün, L.S., Onem, E., Güneri, P., Comparative radiopacity of six flowable resin composites (2010) Oper Dent, 35, pp. 436-440Lasko, T.A., Bhagwat, J.G., Zou, K.H., Ohno-Machado, L., The use of receiver operating characteristic curves in biomedical informatics (2005) J Biomed Inform, 38, pp. 404-415Diniz, M.B., Rodrigues, J.A., Neuhaus, K.W., Cordeiro, R.C., Lussi, A., Influence of examiner's clinical experience on the reproducibility and accuracy of radiographic examination in detecting occlusal caries (2010) Clin Oral Investig, 14, pp. 515-523Zoellner, A., Diemer, B., Weber, H.P., Stassinakis, A., Gaengler, P., Histologic and radiographic assessment of caries-like lesions localized at the crown margin (2002) J Prosthet Dent, 88, pp. 54-59Ferreira, R.I., Haiter-Neto, F., Tabchoury, C.P., de Paiva, G.A., Bóscolo, F.N., Assessment of enamel demineralization using conventional, digital, and digitized radiography (2006) Braz Oral Res, 20, pp. 114-119Peker, I., Toraman Alkurt, M., Altunkaynak, B., Film tomography compared with film and digital bitewing radiography for proximal caries detection (2007) Dentomaxillofac Radiol, 36, pp. 495-49
