Abstract
To evaluate how physical photostimulable phosphor (PSP) plate artifacts, such as those created by scratches, phosphor degradation, and surface peeling, affect the radiologic interpretation of periapical inflammatory disease. A novel technique was developed to digitally superimpose 25 real PSP artifact masks over 100 clinical complementary metal oxide semiconductor (CMOS) periapical images with known radiologic interpretations. These images were presented to 25 general dentists, who were asked to state their radiologic interpretations, their confidence in their interpretations, and their opinions on whether the plates should be discarded. Statistical analyses were conducted by using random intercept mixed models for repeated measures and χ2 tests of the pooled data. No statistically significant adverse effect on interpretation was seen, even at severe artifact levels. There was a statistically significant decrease in the clinicians' confidence and an increase in discard proportions when interpreting images with severe PSP plate artifacts (P < .05). Although diagnostic efficacy was unaffected, clinicians' confidence decreased and proportionally more clinicians opted to discard sensors when interpreting images with severe artifacts. Future studies on the effects of artifacts on the efficacy of diagnosis of other dental diseases are recommended. Ultimately, these results can guide recommendations for PSP plate quality assurance.
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