Fundamental and Clinical Evaluation of Dual Imaging Plate (DIP) Intraoral Radiography

Abstract Objectives To investigate the clinical applicability of dual-imaging plate (DIP) intraoral radiography by evaluating image quality and diagnostic usefulness under varying X-ray beam angles and exposure conditions. Methods In Experiment 1, aluminum step wedges and rectangular wave charts were used to evaluate the impact of X-ray beam angle and exposure dose on the contrast-to-noise ratio (CNR) and square wave response function (SWRF) across DIP, front imaging plate (FIP), and single imaging plate (SIP) images. In Experiment 2, intraoral radiographs were obtained from 19 adult volunteers, and the diagnostic utility of DIP images was subjectively evaluated. Results Despite angled-beam irradiation and elevated doses, DIP images exhibited a significantly higher CNR than SIP and FIP images, with no significant difference in SWRF curves. In clinical cases, DIP images were consistently rated as superior to FIP images for anatomical structure visibility, with large effect sizes. However, inter-rater agreement was poor, possibly due to individual contrast preferences. Conclusions The DIP method offers enhanced image contrast without sacrificing spatial resolution, even at clinically realistic irradiation angles and dose levels, suggesting its clinical utility for reducing radiation exposure while preserving diagnostic accuracy.