Comparing the performance of storage phosphor plate and Insight film images for the detection of proximal caries depth.

OBJECTIVES: To compare proximal caries depth between conventional film images, unenhanced and enhanced storage phosphor plate images. METHOD: Bitewing radiographs were taken on 100 patients presenting for Conservative and Periodontal treatment. Only one bitewing was taken on a patient either the right or left hand side of the patient A DenOptics storage phosphor plate and size 3 Kodak Insight film were simultaneously placed into a Rinn bitewing holder. The Insight film was placed behind the phosphor plate. Both were simultaneously exposed to radiation. The unenhanced phosphor plate images were copied four times. Contrast and brightness were either increased or decreased on the copied images. A five point scale was chosen for proximal caries depth: 0--sound, 1--caries in enamel, 2--caries reaching dentino-enamel junction, 3--caries into dentine, 4--caries in a restored area. The bitewing images were evaluated by 4 clinicians. Images with technical errors were excluded from the study. RESULTS: Altogether 1848 tooth surfaces were evaluated of which 136 surfaces were excluded due to technical errors. The results show that for the detection of proximal caries there is no significant difference in accuracy between unenhanced storage phosphor plate and Kodak Insight film images (p > 0.001). When decreasing both contrast and brightness there was no significant difference in diagnostic accuracy (p > 0.001) between unenhanced and enhanced storage phosphor plate images. More surfaces were analyzed for caries into the dentine on the enhanced images when both contrast and brightness were increased. CONCLUSION: Although contrast-enhanced and brightness-enhanced images retween conventional film, unenhanced and enhanced images.