Digital radiographic images can be indirect, direct, or semi-direct. Radiographic produced by flatbed scanners with a transparency adapter, slide scanners, and digital cameras are referred to as indirect digital radiographs. Direct digital images are acquired using a solid-state sensor such as CCD or complementary metal–oxide–semiconductor (CMOS)-based chips. Semi-direct images are obtained using a phosphor plate system charge-coupling transfers the number of electrons deposited in each pixel from one well to the next in a sequential manner to a readout amplifier for image display on the monitor. Area digital sensor array is used for intraoral radiography while linear arrays are used in extraoral imaging. CMOS sensors use an active pixel technology.
Contrast resolution is an important parameter in the diagnostic accuracy of caries detection. Software allows image manipulation by applying specific filters to detect carious lesions. For periodontal diagnosis, the high resolution of intraoral radiography helps the visualization of the bony supporting tissues, including small details such as periodontal ligament space, lamina dura, and bony trabecularization.[3] Digital imaging allows measuring bone loss extent using image analysis tools. High-resolution technology and/or dedicated endodontic filtering improves the visibility of small file tips as small as 0.06 mm. Serial radiographs with identical geometric projection and exposure settings can be subtracted using digital subtraction radiography. This allows for qualitative evaluation by underscoring small changes such as caries progression, periapical lesions, or even quantitative evaluation of periodontal bone loss.
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