Subjective image quality comparison between two digital dental radiographic systems and conventional dental film

Digital radiography has become an integral part of dentistry. Digital radiography does not require film or dark rooms, reduces X-ray doses, and instantly generates images. The aim of our study was to compare the subjective image quality of two digital dental radiographic systems with conventional dental film.

A direct digital (DD) 'Digital' system by Sirona, a semi-direct (SD) digital system by Vista-scan, and Kodak 'E' speed dental X-ray films were selected for the study. Endodontically-treated extracted teeth (n = 25) were used in the study. Details of enamel, dentin, dentino-enamel junction, root canal filling (gutta percha), and simulated apical pathology were investigated with the three radiographic systems. The data were subjected to statistical analyzes to reveal differences in subjective image quality.

Conventional dental X-ray film was superior to the digital systems. For digital systems, DD imaging was superior to SD imaging.

Conventional film yielded superior image quality that was statistically significant in almost all aspects of comparison. Conventional film was followed in image quality by DD, and SD provided the lowest quality images. Conventional film is still considered the gold standard to diagnose diseases affecting the jawbone.

Improved software and hardware for digital imaging systems are now available and these improvements may now yield images that are comparable in quality to conventional film. However, we recommend that studies still use more observers and other statistical methods to produce ideal results.