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Aim of our study was to determine sensitivity and specificity of three digital intraoral x-ray systems referred to histological tooth hardcut as the golden standard. Material & methods: Using Digora® (Gendex Co.), Sidexis® (Sirona Co.) and Vistascan® (Dürr Co.) of 29 extracted human teeth x-ray pictures were made. Those pictures were analysed by 10 examiners using a five-point-scale. Thereafter all teeth were embedded in polyester pour-resin GTS (Voss Chemie Co.) and cut into about 200μm thick slices using a diamond sawband (Exakt Apparatebau, Norderstedt). Results: Sensitivity and specificity were determined under two options. Calculation variation 1 showed grade 1 as healthy and grades 2, 3, 4 and 5 as diseased. Calculation variation 2 showed grades 1, 2 and 3 as healthy and grades 4 and 5 as diseased. Best diagnostic results according to sensitivity and specificity achieved Sidexis®-x-ray system followed by Digora® system. Lower results achieved Vistascan®-x-ray system. An increased number of wrong negative findings showed that the extension of decayed lesion appeared to be smaller on x-ray than on hardcut specimen. With high probability a nondecayed tooth gets recognized as such. More difficult is to diagnose caries near the pulp (C5). Probability to diagnose correctly a caries transitioning from enamel to dentin is with 6,4% of all C3-diagnoses very low. Because of this x-ray caries diagnosis can only be used ad an additional method to other diagnostic procedures.