Two digital imaging systems, a video camera and analog-to-digital converter, and a charge-coupled device linear photodiode array slide scanner, were tested for their suitability in quantitative studies of periodontal disease. The information content in the original films was estimated, and digital systems were assessed according to these requirements. Radiometric and geometric performance criteria for the digital systems were estimated from measurements and observations. The scanner-based image acquisition (digitization) system had no detectable noise and had a modulation transfer function curve superior to that of the video-based system. The scanner-based system was equivalent to the video-based system in recording radiographic film densities and had more geometric distortion than the video-based system. The comparison demonstrated the superiority of the charge-coupled device linear array system for the quantification of periodontal disease extent and activity.