The effect of image enhancements and dual observers on proximal caries detection.

OBJECTIVES: The aim of this study was to determine if the use of certain image enhancements and dual observers had an effect on the detection of caries, dentin extension, and cavitation. STUDY DESIGN: Seven observers viewed unenhanced and enhanced images taken on photostimulable phosphor plates (PSP) and Schick 33 sensors and were asked to determine whether proximal caries lesions, dentin extension, and cavitation were present. Pairs of observers also evaluated the unenhanced PSP images and recorded their confidence. Micro-computed tomography was used as the gold standard. RESULTS: For caries lesion detection, PSP outperformed Schick sensors, although the differences are most likely not clinically significant. Observers (single and dual) and filters had no effect on any of the diagnostic tasks. Schick sensors and unfiltered images were more specific for dentin extension. CONCLUSIONS: Caries detection was statistically greater with the PSP plate, but both detectors allowed for high accuracy. Expensive software or time-consuming consultations did not improve outcomes.