Accuracy of caries detection with four storage phosphor systems and E-speed radiographs

Objective: To evaluate the accuracy of caries detection using four intra-oral storage phosphor plate systems exposed with two different exposure times and one film system. Methods: Under in vitro and standardised conditions 365 approximal and 159 occlusal surfaces were radiographed using four storage phosphor plate systems: DenOptix, Cd-dent. Digora (blue and white plates) and one film system: Ektaspeed Plus. The plates were exposed twice with 10% and 25% of the time needed for the film. Four observers recorded approximal enamel/dentine and occlusal dentine caries using a five-point confidence scale. Caries presence was validated histologically and diagnostic accuracy of the systems by using ROC curve areas (A(z)). Results: The shorter exposure time for approximal caries. Digora(white) (A(z) = 0.68) and Ekta Plus (A(z) = 0.69) were significantly more accurate than the other systems (A(z) = 0.64-0.65). For occlusal caries using the same exposure time, no significant difference was found between the digital systems (A(z) = 0.76-0.77), which all showed to be significantly less accurate than Ekta Plus (A(z) = 0.81). Using the longer exposure time for approximal caries, no significant difference was found between DenOptix (A(z) = 0.68). Digora(blue) (A(z) = 0.69), Digora(white) (A(z) = 0.69) and Ekta Plus (A(z) = 0.69) which were all significantly more accurate than Cd-dent (A(z) = 0.65). For occlusal caries using the same exposure time, Digora(blue) (A(z) = 0.81) was the most significantly accurate of the digital systems. When approximal caries was the diagnostic task, the longer exposure time resulted in significantly higher accuracy with the DenOptix and Digora(blue) systems but not with the Cd-dent and Digora systems. For occlusal caries, the longer exposure time resulted in a significant improvement only with the Digora(blue) system. Conclusion: For approximal caries using the longer exposure time, no significant difference in diagnostic accuracy was found between DenOptix, Digora(blue) Digora(white) and Ekta Plus which were all significantly more accurate than the Cd-dent. For occlusal caries using the longer exposure time. Digora(blue) was found to be the most accurate of the digital systems. The exposure time had an influence on the diagnostic accuracy with the DenOptix and Digora(blue) systems for approximal and with the Digora(blue) System for occlusal caries detection.