Statement of problem: Various intraoral digital radiographic systems are available as alternatives to film-based radiography. Advances in digital radiography enable image manipulation via using enhancement filters such as Emboss and reverse contrast. Objectives: This study was performed to assess the detection accuracy of proximal caries using Emboss and reverse contrast filters. Methods: This in-vitro study was conducted on 40 extracted premolars mounted in acrylic blocks. The teeth were radiographed using complementary metal oxide semiconductor (CMOS) digital sensor. Two observers evaluated images in terms of presence/absence of proximal caries with/without using Emboss and reverse contrast filters. The teeth were then sectioned and histologically examined. Diagnostic accuracy of each method was assessed using receiver operating characteristic (ROC) curve analysis. Comparisons were made using Wilcoxon signed rank test. Results: There were no significant differences between the Emboss enhanced and original digital (P=0.329) or reverse contrast and original digital (P=0.243) modes in terms of detection accuracy of proximal caries. Analysis of the diagnostic accuracy of Emboss and reverse contrast modes on lesion depth revealed no significant difference. Significant differences were noted between the two observers at their first observation in detection of proximal caries (P=0.034 for Emboss and P=0.005 for reverse contrast). Conclusion: The Emboss and reverse contrast digital enhancement filters do not offer significant improvements in the detection of proximal caries; therefor, their application remains optional based on the practitioners’ individual preferences.
