To compare proximal caries detection using intraoral bitewing, extraoral bitewing and panoramic radiography. 80 extracted human premolar and molar teeth with and without proximal caries were used. Intraoral radiographs were taken with Kodak Insight film (Eastman Kodak Co., Rochester, NY) using the bitewing technique. Extraoral bitewing and panoramic images were obtained using a Planmeca Promax Digital Panoramic X-ray unit (Planmeca Inc., Helsinki, Finland). Images were evaluated by three observers twice. In total, 160 proximal surfaces were assessed. Intra- and interobserver kappa coefficients were calculated. Scores obtained from the three techniques were compared with the histological gold standard using receiver operating characteristic analysis. Az values for each image type, observer and reading were compared using z-tests, with a significance level of α = 0.05. Kappa coefficients ranged from 0.883 to 0.963 for the intraoral bitewing, from 0.715 to 0.893 for the extraoral bitewing, and from 0.659 to 0.884 for the panoramic radiography. Interobserver agreements for the first and second readings for the intraoral bitewing images were between 0.717 and 0.780, the extraoral bitewing readings were between 0.569 and 0.707, and the panoramic images were between 0.477 and 0.740. The Az values for both readings of all three observers were highest for the intraoral bitewing. Az values for the extraoral bitewing images were higher than those of the panoramic images without statistical significance (p > 0.05). Intraoral bitewing radiography was superior to extraoral bitewing and panoramic radiography in diagnosing proximal caries of premolar and molar teeth ex vivo. Similar intra- and interobserver coefficients were calculated for extraoral bitewing and panoramic radiography.

Since the introduction of cone-beam computed tomography (CBCT), several novel systems with different technical specifications and settings have become commercially available. Therefore, it is essential to evaluate CBCT systems for differences in the subjective quality of images obtained for various dental procedures. We evaluated the subjective image quality of cross-sectional scans obtained from various CBCT systems. Images of three cadaver mandibles were obtained from four different CBCT units: 1) Veraviewepocs 3D 40 × 40 mm field of view (FOV) (voxel size: 0.125 × 0.125 × 0.125 mm), 2) Iluma, low-resolution (voxel size: 0.3 × 0.3 × 0.3 mm), 3) Kodak, 50 × 3.7 cm FOV (voxel size: 0.076 × 0.076 × 0.076 mm), and 4) Vatech 12 × 8.5cm FOV (voxel size: 0.160 × 0.160 × 0.160 mm). We assessed subjective image quality and the visibility of 10 specific features, namely, caries, amalgam restoration, final implant drill, root canal filling, metal crown, mandibular canal, mental foramen, tooth (periodontal ligament space and lamina dura), trabecular pattern, and soft tissue. Images were viewed and scored by five calibrated observers, and image quality was ranked from best to worst. The Veraviewepocs 3D had the highest quality images for most of the assessed features, whereas the Iluma low-resolution scans were rated as the lowest quality images. (J Oral Sci 53, 501-508, 2011)