Bitewing examination with four digital receptors

To evaluate recording errors and patient discomfort during bitewing examinations using four digital receptors.

Seventy-eight patients had two bitewings taken on each side of the mouth with the intention of displaying the tooth surfaces from the distal surface of the canine to the distal surface of the most posterior molar, using four digital receptors, two charge-coupled device (CCD) and two photostimulable phosphor (PSP) systems. The patients scored their feelings of discomfort during the examination on a visual analogue scale. Receptor positioning errors in the sagittal plane were determined from the tooth surfaces present on each image and in the vertical plane from the presence of the alveolar bone crest. Cone positioning errors were determined from cone cuts.

Canine and premolar surfaces were more often not depicted on the CCD images than on the PSP images (P<0.05). Cone cuts occurred in 19% of DenOptix images, in 9% of Digora images and in one Planmeca image. The bone crest was more often missing in the upper jaw on Planmeca images than on PSP images (P<0.01). In the lower jaw, Trophy images more often missed the bone crest than the other systems (P<0.05). Patients ranked the receptors as follows (with increasing discomfort): DenOptix, Planmeca, Digora and Trophy, with all being significantly different (P<0.05).

It was more difficult to correctly position CCD sensors than PSP plates in the vertical plane, resulting in more images with missing alveolar bone crest. CCD sensors most often did not display the most anterior surfaces in a bitewing examination.