Objectives: The aim of this study was to compare the intra-oral radiographic images obtained by a PSP system (Orex) with that obtained using E-speed films, in terms of image quality, radiation dosage and diagnostic value. Methods: The physical measurement of image quality was conducted with an aluminum step-wedge. Radiation dosage was measured with a dosimeter. Fog and base levels were measured by developing unexposed films and scanning unexposed PSP plates. The in vitro model included preparation and radiologic evaluation of approximal artificial lesions in premolars and molars in depths ranging from 0.25 mm to 1.00 mm. Radiographs were evaluated for the existence of a lesion and its size by 8 clinicians. Results: Relative contrast was similar in both methods. The resolution power of the digital system was lower than E-speed film. As for the subjective evaluation of artificial lesions, there was no significant difference between the two methods excluding those tooth images without lesions where the analog method was found to be more accurate. Conclusions: The “Orex” PSP system is suitable for clinical purposes and provides good image quality and diagnostic information with reduced exposure when compared with E speed film.

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