A comparison of older and newer versions of intraoral digital radiography systems: diagnosing noncavitated proximal carious lesions.

Background: The authors conducted a study to compare the accuracy of an older and newer version of two intraoral digital systems in terms of radiographic detection of proximal carious lesions.

Methods: Under in vitro and standardized conditions, the authors obtained radiographs of 160 noncavitated proximal surfaces using the Digora FMX (Soredex, Tuusula, Finland), the Digora Optime, the Schick CDR (Schick Technologies, Long Island City, N.Y.) and the Schick CDR Wireless (Schick Technologies) systems. Eight observers recorded proximal carious lesions on a five-point confidence scale. The presence of caries was validated histologically.

Results: The new digital systems (Digora Optime and Schick CDR Wireless) had significantly higher sensitivities than their predecessors. The authors found no significant differences in specificity among the Digora FMX, Schick CDR and Schick CDR Wireless systems, all of which had a significantly higher specificity than did the Digora Optime system (P < .02). The positive predictive value for the Digora Optime system was affected by its high sensitivity and low specificity, and it was lower than that for the two CDR systems (P < .02).

Conclusions: Regarding overall accuracy, the difference between the older and newer versions of the photostimulable storage phosphor and complementary metal oxide semiconductor systems was not statistically significant. However, the authors found more false-positive diagnoses made with the Digora Optime system than with the Digora FMX system.

Clinical Implications: Though the difference in specificities was statistically significant, the authors question whether the difference between the Digora Optime and the other systems is clinically relevant. Therefore, dentists can purchase any of these systems after considering factors other than those evaluated in this study.