![]() ![]() As with conventional radiography, lighting conditions are important for digital image evaluation 16., 20., 21., but observers’ performance was found to be independent of the visual characteristics of the display monitors 22., 23., 24. Furthermore, clinicians must adapt to digital images, which have a smaller surface than film for example, the total active area of a size 2 film is 1,235 mm 2, whereas similar size digital sensors have active areas in the range of 802–940 mm 2 only. Image quality also can be affected by placement of the rigid sensor in the mouth, a manoeuvre that is more challenging than placement of film 3. using prefabricated phantoms or cadavers 16., 17., 18., 19. ![]() Subjective image-quality evaluation has reportedly been performed by a small number of evaluators, using several digital systems and usually ‘ in vitro’ 13., 14., 15. As stated, ‘there is a continuous need for the evaluation of new digital intraoral radiography systems that appear on the market, first and foremost for their image quality…’ 12. This is because ‘defining image quality is a complicated process…part of a longer chain of procedures and actions’ 7. In addition, studies have shown that there is no significant difference in the sensitivity and specificity of the detection of dentinal caries using digital or film-based bitewings 10., 11.The topic of image quality generated by intraoral digital sensors is complex. The detection of primary and recurrent caries is similar for digital images and for film 10., 11. A recent study determined that the performance in this regard is precise for files up to a size of 6 9. Early digital systems were useful in evaluating endodontic file lengths up to a size of 15 8. It has already been shown that intraoral digital sensors provide diagnostic images. The CMOS technology is currently incorporated in the products of several leading manufacturers. There is debate as to which technology is most advantageous CMOS sensors have lower energy requirements, but both CCD and CMOS sensors are capable of capturing 12-bit images and have clinically acceptable spatial resolution 3., 7. Intraoral solid-state rigid sensors are based on either the charge-coupled device (CCD) or the complementary metal–oxide–semiconductor (CMOS) technologies. Overall, the vast majority of owners of digital imaging systems are satisfied and believe that productivity is increased 3. ![]() Others have asserted that the most significant advantages of digital radiography are image archiving and access, computer-aided image interpretation and tools for image enhancement 7. Dentists reported that in addition to the lack of chemicals, lower levels of exposure, ease and cost of imaging storage and the perceived time saving, improved clinical image is a prime motive for integrating this technology in practice 5., 6. The most significant factor in deciding whether to include digital imaging in a dental practice is availability and the cost of the computer system. Among the digital technologies predicted to be incorporated in practice, digital radiography is quickly becoming the leading imaging technique in dentistry 3. The percentage of users of digital radiography was reported to be 30% in 2010 and the expectation is that this trend will continue to increase 4. In 2000, it was estimated that 5% of practitioners in North America used digital radiography 2, and in 2005, 25% of the surveyed dentists used some form of digital radiography and 18% had planned to purchase digital equipment within 1 year 3. Already in the 1990s, 66.8% of dentists in the USA used computers in their practice 1. The use of computing and digital technologies is an emerging trend in dentistry. Further research should be directed towards determining the clinical significance of the differences in image quality reported in this study. Conclusions: None of the sensors was considered to generate images of significantly better quality than the other sensors tested. Other comparisons resulted in non-significant results. The Image Works sensor image was rated the lowest by all clinicians. Results: The Dexis sensor was ranked significantly better than Sirona and Carestream-Kodak sensors and the image captured using the Carestream-Kodak sensor was ranked significantly worse than those captured using Dexis, Schick and Cyber Medical Imaging sensors. Analytical methods used to evaluate clinical image quality included the Visual Grading Characteristics method, which helps to quantify subjective opinions to make them suitable for analysis. Methods: Eighteen clinicians ranked the quality of a bitewing acquired from one subject using eight different intraoral sensors. Purpose: To evaluate the image quality generated by eight commercially available intraoral sensors. ![]()
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