Image quality of direct digital intraoral x-ray sensors in assessing root canal length. The RadioVisioGraphy, Visualix/VIXA, Sens-A-Ray, and Flash Dent systems compared with Ektaspeed films.

The Trophy RadioVisioGraphy model 32000 system in Normal Mode, the Trophy RVG-PC in Normal and Archive Mode, the Gendex VIXA/Visualix, the Regam Sens-A-Ray, and the Villa Flash Dent in High-Resolution Mode and Normal Mode were compared with respect to the visibility of endodontic files. Kodak Ektaspeed film served as the reference. An acrylic embedded human skull was prepared for taking radiographs with endodontic files (Kerr files size 10 and size 15) on full root length and 1.5 mm short in upper and lower premolars and molars. Possibilities for enhancement of the digital images were not studied. Receiver operating characteristics curves were derived and the areas under the curves were averaged and compared using Student's t test statistic (p < 0.05). Kodak Ektaspeed film gave acceptable results for both file sizes. Both Trophy RVG units in Normal Mode and the Regam Sens-A-Ray system gave results above the areas under the curves equals 0.95 for the size 15 files. For the size 10 files the values of the areas under the curves of all sensors systems were below this threshold. It is concluded that both RVG units in Normal Mode and the Sens-A-Ray system render a comparable result with conventional radiography in determining root canal length with the use of a size 15 files. All sensor systems were unacceptably inferior to film images when size 10 files were used.