Efficacy of digital intra-oral radiography in clinical dentistry

Objectives: This article emphasizes the comparison of intra-oral digital imaging to film-based imaging. Additional possibilities of digital imaging that may contribute to system efficacy are discussed as well. Study selection: The main subjects for research in digital imaging are image quality, image acquisition, diagnostic quality, image manipulation, automated analysis, and application software. Data sources: Representative articles on these subjects from the international literature are used for this review. Indirect digital imaging still requires film processing, sophisticated film digitizers, and time to digitize film. Although it is not an efficient method for the dental practice, digitization can be very useful for quantitative analysis of radiographs. Direct digital imaging is more efficient than indirect digital imaging. The main advantages are (semi) real time imaging, low X-ray dose requirements, and no need for chemical processing. In spite of a more limited resolution of the images, direct imaging may perform as accurately as film-based imaging. Direct image plate systems can well be used, for instance, for full-mouth series. The main application of direct sensor systems appears to be endodontology and implantology. In summary, direct digital imaging may be as efficient as film-based imaging in clinical dentistry. The computer provides for many additional options in digital imaging, such as the digital storage, compression, and exchange of radiographic information. Image manipulation (e.g. image enhancement, subtraction radiography and image reconstruction) and automated analysis may benefit radiodiagnosis. Conclusion: It can be concluded that digital imaging certainly has great potential, especially with respect to improvement of diagnostic quality and automated image analysis.