Numerical Evaluation of Image Contrast for Thicker and Thinner Objects among Current Intraoral Digital Imaging Systems

The purpose is to evaluate the performance of current intraoral digital detectors in detail using a precise phantom and new method. Two aluminum step wedges in 0.5 mm steps were exposed by two photostimulable phosphor plate (PSP) systems—one with automatic exposure compensation (AEC) and the other without AEC—and a CCD sensor. Images were obtained with 3 doses at 60 kV. The effect of metallic material also was evaluated. The contrast-to-noise ratio (CNR) for thinner steps and the low contrast value (LCV) for thicker steps were obtained. The CCD system was the best under all conditions (P < 0.001), although the Gray value was sensitive to the dose, and the Gray value-dose relation varied greatly. The PSP system with AEC was superior to that without AEC for the LCV (P < 0.001) but was inferior to it regarding the CNR (P < 0.001). CNR and LCV in the PSP system without AEC were not affected by the metallic plate. Intraoral digital imaging systems should be chosen according to their diagnostic purpose. PSP system with AEC may be the best for detecting molar proximal caries, whereas the PSP system without AEC may be better for evaluating small bone regeneration in periodontal disease. The CCD system provided the best performance.