A method of gauging dental radiographs during treatment planning for dental implants.

J Contemp Dent Pract. 2007;8(6):82-8

Authors: Anil S, Al-Ghamdi HS

AIM: The goal of pre-surgical dental implant treatment planning is to position the optimum number and size of implant fixtures to achieve the best restorative results. The purpose of this article is to describe the use of radiographic imaging software to calibrate and measure anatomical landmarks to overcome inherent distortions associated with dental radiographs. The procedure along with its potential use as an adjunct to radiographic interpretation in routine clinical implant practice is presented. BACKGROUND: Diagnostic imaging is an essential component of implant treatment planning, and a variety of advanced imaging modalities have been recommended to assist the dentist in assessing potential sites for implants. Although technological advances have resulted in new imaging innovations for implant dentistry, dental radiography remains the most widely used tool for determining the quantity and quality of alveolar bone as it is a non-invasive procedure. However, the unreliable magnification factor associated with conventional radiographs remains a major problem when estimating the amount of bone available at the implant site. SUMMARY: This image measurement technique is capable of assessing the bone quantity by measuring the height and width of the alveolar crest for a specified region in a two dimensional plane in any direction related to the visible landmarks in the oral cavity. These measurements can be used by the clinician to select the type of implant and its position. Since there is no additional equipment or cost involved, the technique can be used as an important adjunct in implant practice.

PMID: 17846675 [PubMed - indexed for MEDLINE]

Digital subtraction technique for evaluation of peri-implant bone change in digital dental imaging.

Bull Tokyo Dent Coll. 2006 May;47(2):57-64

Authors: Wakoh M, Nishikawa K, Otonari T, Yamamoto M, Harada T, Sano T, Yajima Y, Ooguro T

The purpose of this study was to investigate digital subtraction technique in digital dental imaging for implant performance, used to quantitatively evaluate bone change around dental implants. For longitudinal assessment of peri-implant bone change, we applied subtraction technique to digital peri-apical radiographs using a digital dental imaging system in two cases at the upper canine and premolar regions. In both cases, we found two peaks of bone change at the crestal region; we also quantitatively demonstrated a marked change over the first one-month period and approximately three-month period spanning the fourth month to the end of the sixth month following implantation. Digital peri-apical radiography accommodating the digital subtraction program should be re-acknowledged as a reliable modality for assessing amount of bone change at local implantation sites.

PMID: 17167221 [PubMed - indexed for MEDLINE]

Reproducibility of pixel values for two photostimulable phosphor plates in consecutive standardized scannings.

Braz Oral Res. 2006 Jul-Sep;20(3):207-13

Authors: Freitas P, Yaedú RY, Rubira-Bullen IR, Escarpinati M, Vieira MC, Schiabel H, Lauris JR

The objective of the present study was to determine the reproducibility of the pixel values obtained with the Digora system (Soredex, Finland). Exposures were standardized, with variation in exposure and scanning time of two photostimulable phosphor plates containing a stepwedge image. The smallest variation in pixel values ranged from 50 to 75%, with the widest variations being observed in less dense steps. A significant difference in pixel values was observed in terms of X-ray exposure and scanning times and between the two plates themselves (ANOVA, p < 0.01). Using the present methodology, the reproducibility of pixel values was not satisfactory for the tested white photostimulable plates. This wide variation in digitalization might be influenced by the amount of X-rays that sensitized the plates. It may be important to establish the reproducibility of the pixel values in quantitative studies using digital image.

PMID: 17119702 [PubMed - indexed for MEDLINE]

For the dental patient: digital radiographs - imaging technology for the dental office.

J Am Dent Assoc. 2006 Nov;137(11):1624

Authors:

PMID: 17082288 [PubMed - indexed for MEDLINE]

The use of dental radiographs: update and recommendations.

J Am Dent Assoc. 2006 Sep;137(9):1304-12

Authors:

BACKGROUND AND OVERVIEW: The National Council on Radiation Protection & Measurements updated its recommendations on radiation protection in dentistry in 2003, the Centers for Disease Control and Prevention published its Guidelines for Infection Control in Dental Health-Care Settings in 2003, and the U.S. Food and Drug Administration updated its selection criteria for dental radiographs in 2004. This report summarizes the recommendations presented in these documents and addresses additional topics such as patient selection criteria, film selection for conventional radiographs, collimation, beam filtration, patient protective equipment, film holders, operator protection, film exposure and processing, infection control, quality assurance, image viewing, direct digital radiography and continuing education of dental health care workers who expose radiographs. CONCLUSIONS: This report discusses implementation of proper radiographic practices. In addition to these guidelines, dentists should be aware of, and comply with, applicable federal and state regulations. CLINICAL IMPLICATIONS: Dentists should weigh the benefits of dental radiographs against the consequences of increasing a patient's exposure to radiation and implement appropriate radiation control procedures.

PMID: 16946440 [PubMed - indexed for MEDLINE]

Anatomical variations of mandibular premolars in Chennai population.

Indian J Dent Res. 2006 Jan-Mar;17(1):7-10

Authors: Iyer VH, Indira R, Ramachandran S, Srinivasan MR

AIM: To analyse the prevalence of anatomical variations of mandibular premolars in Chennai population. METHODOLOGY: It was observed, during the routine treatment of mandibular premolars that aberrations were becoming common. This necessitated an encompassing study on 500 patients, evaluating the occurrence of these aberrations. The parameters of this study included sex predilection, unilateral/ bilateral occurrences, and comparison of the incidence of anatomical variations in mandibular first and second premolar canal configuration. The study pattern was designed to observe these premolars using Radiovisiography (RVG) in different angulations to highlight the anatomical aberrations. The results were subjected to statistical analysis, which were performed using SPSS (Statistical Package for Social Science) statistical program version 10.0.5. Descriptive statistics were computed for all the variables. RESULT: The present study revealed high incidence of anatomical aberrations in mandibular premolars among Chennai population. Out of the 500 patients studied, 123 patients [24.6%] showed anatomical variance in the canal configuration. There was high incidence of Vertucci's Type IV canal configuration as compared to Type V, Type II and Type VIII in the descending order of occurrence. CONCLUSION: Within the limitations of this in-vivo study, it was inferred that the incidence of aberrations in the canal configuration of mandibular premolars is common and due considerations are to be given during endodontic intervention.

PMID: 16900889 [PubMed - indexed for MEDLINE]

Comparison of cephalometric measurements from three radiological clinics.

Braz Oral Res. 2006 Apr-Jun;20(2):162-6

Authors: Gon&#xE7;alves FA, Schiavon L, Pereira Neto JS, Nouer DF

The orthodontic documentation carried out in radiological clinics is essential for diagnosis, planning and control of the orthodontic treatment. Amongst the diagnosis elements used are the cephalometric measurements, and errors can be incorporated as they are obtained. The objective of this work was to evaluate the values of some cephalometric measurements obtained in three radiological clinics using 30 lateral cephalometric radiographs of the head randomly chosen from the archives of the Department of Child Dentistry (Discipline of Orthodontics), School of Dentistry of Piracicaba, UNICAMP. These values were compared with the measurements obtained manually (control group) using variance analysis and Tukeys and Friedmans tests. Of the fourteen cephalometric measurements evaluated, the results demonstrated that only four of them presented statistically significant differences: IMPA, 1-NA, FMA, and H-nose. We concluded that although the majority of the mean cephalometric values did not present statistically significant differences, a great variability in the results was found when all the radiographic values were compared. This variability may influence the interpretation of the cephalometric measurements. Hence, we suggest that when the practitioner receives orthodontic documentation, he/she should redo the cephalometric analysis and compare the measurement values found with those presented to him. In addition, the practitioner should be prepared to use other elements for diagnosis, planning and control of the orthodontic treatment.

PMID: 16878211 [PubMed - indexed for MEDLINE]

Assessment of enamel demineralization using conventional, digital, and digitized radiography.

Braz Oral Res. 2006 Apr-Jun;20(2):114-9

Authors: Ferreira RI, Haiter-Neto F, Tabchoury CP, de Paiva GA, Bóscolo FN

This experimental research aimed at evaluating the accuracy of enamel demineralization detection using conventional, digital, and digitized radiographs, as well as to compare radiographs and logarithmically contrast-enhanced subtraction images. Enamel subsurface demineralization was induced on one of the approximal surfaces of 49 sound third molars. Standardized radiographs of the teeth were taken prior to and after the demineralization phase with three digital systems--CygnusRay MPS, DenOptix and DIGORA--and InSight film. Three radiologists interpreted the pairs of conventional, digital, and digitized radiographs in two different occasions. Logarithmically contrast-enhanced subtraction images were examined by a fourth radiologist only once. Radiographic diagnosis was validated by cross-sectional microhardness profiling in the test areas of the approximal surfaces. Accuracy was estimated by Receiver Operating Characteristic (ROC) analysis. Chi-square test, at a significance level of 5%, was used to compare the areas under the ROC curves (A(z)) calculated for the different imaging modalities. Concerning the radiographs, the DenOptix system (A(z) = 0.91) and conventional radiographs (A(z) = 0.90) presented the highest accuracy values compared with the other three radiographic modalities. However, logarithmically contrast-enhanced subtraction images (A(z) = 0.98) were significantly more accurate than conventional, digital, and digitized radiographs (p = 0.0000). It can be concluded that the DenOptix system and conventional radiographs provide better performance for diagnosing enamel subsurface demineralization. Logarithmic subtraction significantly improves radiographic detection.

PMID: 16878203 [PubMed - indexed for MEDLINE]

Digital imaging.

J Am Dent Assoc. 2006 Feb;137(2):152-3; author reply 153

Authors: Schiff T

PMID: 16521379 [PubMed - indexed for MEDLINE]

Making sense of sensors.

J Am Dent Assoc. 2006 Feb;137(2):152; author reply 152

Authors: Boothe M

PMID: 16521378 [PubMed - indexed for MEDLINE]

Contemporary, emerging, and ratified wireless security standards: an update for the networked dental office.

J Contemp Dent Pract. 2006 Feb 15;7(1):174-85

Authors: Mupparapu M

Wireless networking is not new to contemporary dental offices around the country. Wireless routers and network cards have made access to patient records within the office handy and, thereby, saving valuable chair side time and increasing productivity. As is the case with any rapidly developing technology, wireless technology also changes with the same rate. Unless, the users of the wireless networking understand the implications of these changes and keep themselves updated periodically, the office network will become obsolete very quickly. This update of the emerging security protocols and pertaining to ratified wireless 802.11 standards will be timely for the contemporary dentist whose office is wirelessly networked. This article brings the practicing dentist up-to-date on the newer versions and standards in wireless networking that are changing at a fast pace. The introduction of newer 802.11 standards like super G, Super AG, Multiple Input Multiple Output (MIMO), and pre-n are changing the pace of adaptation of this technology. Like any other rapidly transforming technology, information pertaining to wireless networking should be a priority for the contemporary dentist, an eventual end-user in order to be a well-informed and techno-savvy consumer.

PMID: 16491160 [PubMed - indexed for MEDLINE]

Accuracy and consistency of radiographic interpretation among clinical instructors using two viewing systems.

J Dent Educ. 2006 Feb;70(2):149-59

Authors: Lanning SK, Best AM, Temple HJ, Richards PS, Carey A, McCauley LK

Accurate and consistent radiographic interpretation among clinical instructors is needed for assessment of teaching, student performance, and patient care. The purpose of this investigation was to determine if the method of radiographic viewing affects accuracy and consistency of instructors' determinations of bone loss. Forty-one clinicians who provide instruction in a dental school clinical teaching program (including periodontists, general dentists, periodontal graduate students, and dental hygienists) quantified bone loss for up to twenty-five teeth into four descriptive categories using a view box for plain film viewing or a projection system for digitized image viewing. Ratings were compared to the correct category as determined by direct measurement using the Schei ruler. Agreement with the correct choice for the view box and projection system was 70.2 percent and 64.5 percent, respectively. The mean difference was better for a projection system due to small rater error by graduate students. Projection system ratings were slightly less consistent than view box ratings. Dental hygiene faculty ratings were the most consistent but least accurate. Although the projection system resulted in slightly reduced accuracy and consistency among instructors, training sessions utilizing a single method for projecting digitized radiographic images have their advantages and may positively influence dental education and patient care by enhancing accuracy and consistency of radiographic interpretation among instructors.

PMID: 16478929 [PubMed - indexed for MEDLINE]

More about radiography.

J Am Dent Assoc. 2006 Jan;137(1):19-21; author reply 21-3

Authors: Farman AG

PMID: 16456995 [PubMed - indexed for MEDLINE]

Dental radiography.

J Am Dent Assoc. 2006 Jan;137(1):18; author reply 18-9

Authors: Stewart RA

PMID: 16456994 [PubMed - indexed for MEDLINE]

Evaluation of digital optical density of bone repair in rats medicated with ketoprofen.

Braz Dent J. 2005 Dec;16(3):207-212

Authors: Martins MV, Silva MA, Medici Filho E, Moraes LC, Castilho JC, Rocha RF

The purpose of this study was to evaluate the influence of ketoprofen on bone repair process in tibiae of rats by means of analysis of the digital optical density. Twenty Wistar rats were assigned to two groups: an untreated control group and a group treated with ketoprofen. The experimental procedures comprised the following stages: general anesthesia, preparation of a unicortical bone defect on the left tibia of each rat, medication with ketoprofen and radiographic examination. Digital radiographic images were acquired using Visualix GX-S-HDI&trade; digital sensor and an x-ray equipment. Radiographs were taken at baseline, 7, 14, 21 and 30 days postoperatively and the optical density (OD) was evaluated using the Vix winTM 1.4 system. The mean values of OD readings were analyzed statistically by ANOVA and Tukey's test with significance level set at &#xE1;=5%. The control group showed a statistically significant correlation (p=0.001) between time and optical density, while the ketoprofen group exhibited a weak and not statistically significant correlation (p=0.100). The control group presented the smallest OD ratios at days 1 and 7, and the greatest OD ratios at days 14, 21 and 30, with statistically significant difference (p=0.001). There was no significant differences (p=0.100) among the OD ratios in the ketoprofen group, regardless of the evaluation period. The findings of this study suggest that ketoprofen influenced bone repair process because there was an increase in optical density during the first week and delayed new bone formation after the 21st day.

PMID: 16429186 [PubMed - as supplied by publisher]

Digital diagnosis records in orthodontics. An overview.

Med Oral Patol Oral Cir Bucal. 2006 Jan;11(1):E88-93

Authors: Paredes V, Gandia JL, Cibri&#xE1;n R

Digital technology is becoming day by day a more important procedure in most of the clinic activities and, thus, orthodontists are increasingly adding digital technology to their orthodontics records. In this article we want to outline the advantages and disadvantages of the use of digital photography, digital radiography as well as one of the latest developments: the digital study stone casts. We will also present the state of the art related to dentists that use these digital records routinely in our country.

PMID: 16388303 [PubMed - indexed for MEDLINE]

Digital imaging fiber-optic trans-illumination, F-speed radiographic film and depth of approximal lesions.

J Am Dent Assoc. 2005 Dec;136(12):1682-7

Authors: Young DA, Featherstone JD

BACKGROUND: Detection of early carious lesions is a prerequisite to an optimal preventive and minimal surgical intervention strategy. The authors conducted this study to determine whether Digital Imaging Fiber-Optic Trans-Illumination (DIFOTI) (Electro-Optical Sciences, Irvington, N.Y.) could be useful in evaluating early approximal lesions and to compare radiographs produced with F-speed film with both histologic lesion depth and cavitation. METHODS: The authors created artificial approximal lesions in vitro in extracted teeth over 14 weeks and imaged them using a "bitewing-like" view every two weeks with DIFOTI and F-speed radiographic film. At the end of the 14 weeks, the authors examined the lesions for surface cavitation using visual and tactile methods. They then thin-sectioned the lesions and subjected them to histologic analysis using polarized light microscopy (PLM). RESULTS: DIFOTI was not able to measure the depth of a lesion in any of the samples. It was, however, able to show surface changes associated with early demineralization as early as two weeks. The depth of a lesion measured using F-speed radiographic film was not statistically different from the depth of a lesion measured with PLM histologic analysis (P > .05). None of the lesions showed any signs of surface cavitation after 14 weeks of demineralization. CONCLUSIONS AND CLINICAL IMPLICATIONS: DIFOTI technology should not be used to decide between surgical or chemical treatment strategies based on lesion depth. We found that F-speed radiographic film was accurate in the approximating the depth of the lesion histologically. Ideally, the clinical decision whether to cut the tooth should be made based on cavitation rather than histologic lesion depth.

PMID: 16383050 [PubMed - indexed for MEDLINE]

The advantages of minimally invasive dentistry.

J Am Dent Assoc. 2005 Nov;136(11):1563-5

Authors: Christensen GJ

Minimally invasive dentistry, in cases in which it is appropriate, is a concept that preserves dentitions and supporting structures. In this column, I have discussed several examples of minimally invasive dental techniques. This type of dentistry is gratifying for dentists and appreciated by patients. If more dentists would practice it, the dental profession could enhance the public's perception of its honesty and increase its professionalism as well.

PMID: 16329421 [PubMed - indexed for MEDLINE]

Filmless imaging: the uses of digital radiography in dental practice.

J Am Dent Assoc. 2005 Oct;136(10):1379-87

Authors: van der Stelt PF

BACKGROUND: As use of digital radiography becomes more common, many dentists are wondering if and how they can replace conventional film-based imaging with a digital system. This article briefly describes the different technologies used for digital radiography in dentistry. The article provides general practitioners with a broad overview of the benefits and limitations of digital radiography to help them understand the role the technology can play in their practices. OVERVIEW: The two technologies now available are solid-state systems and phosphor plate systems. Each has its strong points, and the choice of which to use depends on the type of dental practice. Image processing improves the diagnostic quality of the radiographic information. Advanced image-processing techniques, such as subtraction radiography, are available for specialized clinics. CONCLUSIONS AND CLINICAL IMPLICATIONS: Digital radiography no longer is an experimental modality. It is a reliable and versatile technology that expands the diagnostic and image-sharing possibilities of radiography in dentistry. Optimization of brightness and contrast, task-specific image processing and sensor-independent archiving are important advantages that digital radiography has over conventional film-based imaging.

PMID: 16255462 [PubMed - indexed for MEDLINE]

Dental digital radiography: more than a fad, less than a revolution.

J Am Dent Assoc. 2005 Oct;136(10):1358, 1360, 1362

Authors: Kantor ML

PMID: 16255459 [PubMed - indexed for MEDLINE]

Assessing the accuracy of caries diagnosis via radiograph. Film versus print.

J Am Dent Assoc. 2005 Mar;136(3):323-30

Authors: Otis LL, Sherman RG

BACKGROUND: The authors conducted this study to determine if proximal caries diagnoses made using bitewing radiographic images printed on photographic paper were comparable with diagnoses made using traditional radiographic film images. METHODS: The authors digitized 15 posterior bitewing radiographs that contained 74 carious and 127 sound unrestored proximal surfaces and printed them on photographic paper. Fourteen dentists evaluated the radiographs and two printed image formats (4 x 3 centimeters and 8 x 6 cm) for evidence of caries. The diagnostic accuracy and interobserver agreement for caries diagnoses obtained in the two printed image formats were compared with those for radiographic film images. RESULTS: Overall, the diagnostic accuracy of printed images did not differ significantly from radiographic film images for dentinal caries. However, for caries limited to the enamel surface, a decrease in sensitivity was noted in six of the 14 observers for the smaller print images, while no significant differences in the diagnoses of enamel caries were observed among any of the observers in the enlarged print format. CONCLUSION: This study provides evidence that printed images can be used to diagnose dental caries reliably. CLINICAL IMPLICATIONS: The results of this study indicate that the diagnostic information obtained by viewing printed images is equivalent to that obtained by viewing standard radiographs. Size of the printed image also may be important in caries diagnosis and care must be taken to print bitewing radiographic images at a size that optimizes interpretation. Other factors that must be considered are the type of printer, printer resolution, paper quality and type of ink used. With careful consideration of printing parameters, clinicians can be assured of diagnostic quality in printed images.

PMID: 15819345 [PubMed - indexed for MEDLINE]

Digital radiography.

J Am Dent Assoc. 2005 Jan;136(1):26; author reply 26

Authors: Rummel JT

PMID: 15693490 [PubMed - indexed for MEDLINE]

Wireless networking for the dental office: current wireless standards and security protocols.

J Contemp Dent Pract. 2004 Nov 15;5(4):155-62

Authors: Mupparapu M, Arora S

Digital radiography has gained immense popularity in dentistry today in spite of the early difficulty for the profession to embrace the technology. The transition from film to digital has been happening at a faster pace in the fields of Orthodontics, Oral Surgery, Endodontics, Periodontics, and other specialties where the radiographic images (periapical, bitewing, panoramic, cephalometric, and skull radiographs) are being acquired digitally, stored within a server locally, and eventually accessed for diagnostic purposes, along with the rest of the patient data via the patient management software (PMS). A review of the literature shows the diagnostic performance of digital radiography is at least comparable to or even better than that of conventional radiography. Similarly, other digital diagnostic tools like caries detectors, cephalometric analysis software, and digital scanners were used for many years for the diagnosis and treatment planning purposes. The introduction of wireless charged-coupled device (CCD) sensors in early 2004 (Schick Technologies, Long Island City, NY) has moved digital radiography a step further into the wireless era. As with any emerging technology, there are concerns that should be looked into before adapting to the wireless environment. Foremost is the network security involved in the installation and usage of these wireless networks. This article deals with the existing standards and choices in wireless technologies that are available for implementation within a contemporary dental office. The network security protocols that protect the patient data and boost the efficiency of modern day dental clinics are enumerated.

PMID: 15558101 [PubMed - indexed for MEDLINE]

Why switch to digital radiography?

J Am Dent Assoc. 2004 Oct;135(10):1437-9

Authors: Christensen GJ

PMID: 15551985 [PubMed - indexed for MEDLINE]

Bitewing and digital bitewing radiography for detection of caries lesions.

J Dent Res. 2004;83 Spec No C:C72-5

Authors: Wenzel A

When radiography is applied in the clinic for caries detection, the recommended technique is bitewing projection (Gr&#xF6;ndahl, 1994). This technique was introduced by Raper (1925) and has continued with only minor alterations. The aims of this report are to provide evidence for (1) optimal bitewing recording for individual examinations and clinical trials, (2) advantages and disadvantages of digital receptors for bitewing examinations, (3) the diagnostic outcomes and limitations of bitewing radiography, and (4) computer-automated detection of caries.

PMID: 15286126 [PubMed - indexed for MEDLINE]

Storage phosphor plates: how durable are they as a digital dental radiographic system?

J Contemp Dent Pract. 2004 May 15;5(2):57-69

Authors: Bedard A, Davis TD, Angelopoulos C

The aim of this in vitro investigation was to evaluate the durability of storage phosphor plates (SPPs) as a digital dental imaging system and to detect the factors that may contribute to possible reduced durability. A total of 140 new SPPs were divided into groups and exposed to the effects of the various handling steps during the image acquisition. An additional group of plates joined the existing plates in the Radiology Clinic and tested the additive effect of all these factors plus the effect of positioning the plates in a patient's mouth. The images resulting from these SPPs were regularly evaluated for the appearance of scratches as a sign of wear and rated by an oral radiologist using a 6 point scale. Although the manufacturer claims the SPPs can be used indefinitely, we found 95% of our plates were rendered non-diagnostic after only 50 uses. The manufacturer's claim for indefinite use of the SPPs seems to be questionable.

PMID: 15150634 [PubMed - indexed for MEDLINE]

Comparison of direct digital and conventional intraoral radiographs in detecting alveolar bone loss.

J Am Dent Assoc. 2003 Nov;134(11):1468-75

Authors: Khocht A, Janal M, Harasty L, Chang KM

BACKGROUND: Intraoral radiographs are important diagnostic aids in periodontics. The authors conducted a study to compare estimates of bone levels from direct digital and conventional radiographic under normal clinical use. METHODS: A full-mouth series of conventional radiographs was taken for each of 25 subjects who had periodontitis. A long cone paralleling technique was used for periapical, or PA, images, and a paper sleeve with biting tab was employed for bitewing, or BW, images. A set of direct digital radiographs matching the conventional radiographs was taken for each subject under the same conditions. The distance from the cementoenamel junction to the interproximal alveolar crest on all readable surfaces was measured. RESULTS: Examiners measured 857 PA image sites and 315 BW image sites matched on both radiographic systems. Paired t test showed significant differences in bone levels between the two systems. Measurements from conventional PA images were higher in all maxillary sextants (P < or = .02), and measurements from digital PA images were higher in mandibular anterior sextants (P = .007). Measurements in digital BW images were higher in mandibular posterior sextants (P = .002). A chi2 analysis of categorical bone levels (normal, early-to-moderate loss or advanced loss) showed significant differences between the imaging systems in revealing bone levels in both PA (P < .04) and BW (P < .001) images. Digital radiographs showed a higher number of sites with bone loss than did conventional radiographs. CONCLUSIONS: Under normal clinical use, alveolar bone levels revealed on intraoral direct digital radiographs differ from those revealed on conventional radiographs. CLINICAL IMPLICATIONS: Intraoral direct digital radiographs are not an equivalent substitute for conventional radiographs in evaluating alveolar bone levels.

PMID: 14664265 [PubMed - indexed for MEDLINE]

[Digitized dental image evaluation system]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2003 Aug;59(8):927-31

Authors: Maruhashi K

PMID: 12960944 [PubMed - indexed for MEDLINE]

Measurement of the optical density of packable composites: comparison between direct and indirect digital systems.

Pesqui Odontol Bras. 2002 Oct-Dec;16(4):299-307

Authors: Graziottin LF, da Costa NP, da Silveira ID, Veeck EB

The aim of this study was to measure the optical density of four packable composite resins with widths of 1, 2, 3 and 4 mm, by means of Digora (direct) and DentScan DentView (indirect) digital imaging systems, in order to compare both methods. Twenty acrylic plates, with the proposed thicknesses, were used, each one containing a sample of each resin. Each acrylic plate was radiographed three times, under a standardized technique. For the Digora system, an optical plate was used under each resin sample, and, for the DentScan DentView system, occlusal films were employed, totalizing 60 exposures for each system. Optical plates and films were scanned and three consecutive optical readouts were carried out, totalizing 1,440 readouts. The results were submitted to statistical analysis and revealed that the average optical density of the four resins always increased as thickness increased. Regarding the comparisons between the composite resins, in both analysis the resin with the greater optical density was Surefil followed by Prodigy Condensable, Alert and Solitaire . The correlations between the results of Digora and DentScan DentView were significant for the different thicknesses and materials. The observed tendency is that as the values obtained with the Digora system increase, so do the values obtained with DentScan DentView . While thickness increased, the values of optical density in both Digora and DentScan DentView tended to approach each other. The Digora system presented smaller amplitude between the results obtained in adjacent thicknesses.

PMID: 12612767 [PubMed - indexed for MEDLINE]

Panoramic and cephalometric extraoral dental radiograph systems.

J Am Dent Assoc. 2002 Dec;133(12):1696-7

Authors:

The basic unit is the Orthopantomograph OP100, which is a computer-controlled extraoral imaging system capable of producing panoramic radiographs using either film or digital technology. This unit has automatic exposure control, automatic spine compensation, a patented V-shaped X-ray beam and a built-in quality assurance program. The OP100 is available with cephalometrics (the OC100 model), linear tomography (the Ortho Trans model), identification film marking (the Ortho ID model) and imaging software (the Ortho Zone and Ortho TMJ models). The addition of a cephalometric arm to the Orthopantomograph makes the unit an Orthoceph. The image receptor sizes are as follows: Panorama OP100: cassette 15 x 30 centimeters; Cephalometric image receptor OC100: 24 x 30 cm, 18 x 24 cm, 8 x 10 inches; Panoramic image receptor OP100D: CCD camera, image pixel size 90 x 90 micrometers; Cephalometric image receptor OC100D: CCD camera, image pixel size 90 x 90 microm.

PMID: 12512672 [PubMed - indexed for MEDLINE]

[Digital sampling limitation on the dental radiograph]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2002 Nov;58(11):1469-75

Authors: Sumida H

PMID: 12469025 [PubMed - indexed for MEDLINE]

Digital radiography: an overview.

J Contemp Dent Pract. 2002 Nov 15;3(4):23-39

Authors: Parks ET, Williamson GF

Since the discovery of X-rays in 1895, film has been the primary medium for capturing, displaying, and storing radiographic images. It is a technology that dental practitioners are the most familiar and comfortable with in terms of technique and interpretation. Digital radiography is the latest advancement in dental imaging and is slowly being adopted by the dental profession. Digital imaging incorporates computer technology in the capture, display, enhancement, and storage of direct radiographic images. Digital imaging offers some distinct advantages over film, but like any emerging technology, it presents new and different challenges for the practitioner to overcome. This article presents an overview of digital imaging including basic terminology and comparisons with film-based imaging. The principles of direct and indirect digital imaging modalities, intraoral and extraoral applications, image processing, and diagnostic efficacy will be discussed. In addition, the article will provide a list of questions dentists should consider prior to purchasing digital imaging systems for their practice.

PMID: 12444400 [PubMed - indexed for MEDLINE]

Two decades of computerized information technologies in dental radiography.

J Dent Res. 2002 Sep;81(9):590-3

Authors: Wenzel A

PMID: 12202637 [PubMed - indexed for MEDLINE]

Evaluation of a digital measurement tool to estimate working length in endodontics.

J Contemp Dent Pract. 2001 Feb 15;2(1):24-30

Authors: Lamus F, Katz JO, Glaros AG

The purpose of the study was to compare the segmental measurement tool from the Shick Technologies CDR digital system with the conventional film radiography measurement technique to determine preoperative working length. Natural extracted human teeth with varying degrees of root curvature were used. All teeth were imaged using the Shick Technologies CDR direct digital system and conventional E-speed film. Measurements from digital radiography and conventional film were compared with measurements made directly from the endodontic files. The Wilks' Lambda multivariate test was used. The mean measurement of each modality was compared with the other and with the gold standard. The test showed statistically significant differences between the two modalities at p<0.05. The mean measurements for both modalities were not significantly different from the gold standard. The modality most closely approaching the gold standard was the conventional film.

PMID: 12167941 [PubMed - indexed for MEDLINE]

Capabilities of computerized clinical decision support systems: the implications for the practicing dental professional.

J Contemp Dent Pract. 2002 Feb 15;3(1):27-42

Authors: Umar H

This article presents the use of captured data within the range of patient care activities of the dental practitioner with an emphasis on prosthodontic activities. It describes the use of computer technology in dentistry during a typical patient encounter in a dental care facility. The oral health record, the need for speech recognition technology, and existing documentation software are discussed. Ongoing development of the capabilities of Clinical Decision Support (CDS) systems is becoming an important part of the oral health setting; including systems applicable to prosthodontics. These systems all rely on a common standardized structure for the electronic (oral) health record (EHR/EOHR). Current developments in radiological technology and digital imaging are explained as well as fundamentals of decision support systems clarified. Recent developments in the representation of domain knowledge as well as the implementation of a dental nomenclature and metathesaurus are also presented. A quality matrix identifies target values for dental informatics while demonstrating an "importance-weighting" of dental characteristics.

PMID: 12167911 [PubMed - indexed for MEDLINE]

The efficacy of a computerized caries detector in intraoral digital radiography.

J Am Dent Assoc. 2002 Jul;133(7):883-90

Authors: Gakenheimer DC

BACKGROUND: A unique software tool has been developed to assist dentists in the difficult task of diagnosing radiographs for proximal caries. The software, called Logicon Caries Detector (Northrop Grumman Information Technology, Herndon, Va.), extracts image features and correlates them with a database of known caries problems. The Logicon software was combined with the digital radiography system Trophy RadioVisioGraphy (Trophy Radiologie, Croissy-Beaubourg, France) and its effectiveness was measured in a clinical study, the results of which are reported here. METHODS: The manufacturer trained 18 dentists in private practices and one university clinic across the United States to use the Logicon Caries Detector software. The dentists diagnosed 175 surfaces with potential caries and adjacent teeth expected to be clean but included as control surfaces. The dentists first did a visual diagnosis only and then repeated the diagnosis using the software. If their final diagnosis called for it, a restoration was performed and the depth of caries was recorded. RESULTS: Effectiveness was gauged by calculating three measures of performance-sensitivity, specificity and accuracy-for dentin caries diagnosis by each dentist both before and after using Logicon Caries Detector. Sensitivity among all dentists before using the Logicon software was 70.3 percent and afterward was 90.5 percent, an improvement of 20.2 percent. Dentists' specificity was 88.6 percent before using the software and 88.3 percent afterward, with a difference of-0.3 percent. Dentists' accuracy was 75.6 percent before using the software and 88.3 percent afterward, with an improvement of 12.7 percent. CONCLUSIONS: Logicon Caries Detector enabled dentists to find 20 percent more cases of caries penetrating into dentin than they were able to find without it, while not causing them to mistreat any additional healthy teeth. CLINICAL IMPLICATIONS: Digital radiography and smart software like Logicon Caries Detector will improve dentists' diagnostic abilities and lead to better patient care.

PMID: 12148682 [PubMed - indexed for MEDLINE]

Comparisons of physical imaging properties among three kinds of imaging plates used in photostimulable phosphor systems for dental radiography.

Bull Tokyo Dent Coll. 2002 Feb;43(1):23-30

Authors: Nishikawa K, Ooguro T, Kuroyanagi K

The purpose of this study was to compare the physical imaging properties of three kinds of imaging plates (IPs) used with two photostimulable phosphor systems for dental radiography: HR-V, used with the Digora, BAS-SR, and ST-V, used with the DenOptix for intraoral radiography and panoramic radiography, respectively. Sensitivity to X-ray, gradient, modulation transfer function (MTF), noise power spectrum (NPS), noise-equivalent quanta (NEQ), and detective quantum efficiency (DQE) were compared. All imaging plates were read using the DenOptix scanner with inactive automatic range control (ARC). The scanning resolution was set at 300 dpi. Decay of image information by room light was also compared at inactive and active ARC settings. BAS-SR showed the lowest sensitivity, the lowest gradient, the highest MTF, and the highest NPS. ST-V showed the highest sensitivity, the highest gradient, the lowest MTF, and the lowest NPS. HR-V was the second best for all imaging properties examined in this study. NEQ and DQE of BAS-SR were lowest, and those of ST-V were highest at low spatial frequencies. However, BAS-SR showed relatively constant NEQ and DQE while those of ST-V decreased remarkably at high spatial frequencies. NEQ and DQE of HR-V were the second best at low spatial frequencies and the best at high spatial frequencies. Therefore, we concluded that HR-V has the best imaging properties for dental radiography among three kinds of IPs evaluated in this study. However, the light decay speed of image information with HR-V was remarkably faster than with BAS-SR. To adopt HR-V for a system with which IPs are treated in an ordinary room, the light decay should be taken into account.

PMID: 12013822 [PubMed - indexed for MEDLINE]

An introduction to digital radiography in dentistry.

J Orthod. 2002 Mar;29(1):66-9

Authors: Brennan J

The aim of this article is to explain the basic principles of digital radiography, and to discuss the intra- and extra-oral imaging systems currently available. There are two main types of digital sensors available. One is based on charge coupled device technology and the other consists of phosphor storage plates. The advantages and disadvantages of each are highlighted with particular attention to orthodontics.

PMID: 11907314 [PubMed - indexed for MEDLINE]

Future is digital.

Br Dent J. 2001 Oct 27;191(8):418

Authors: Wade JT

PMID: 11720012 [PubMed - indexed for MEDLINE]

Systematic reviews of selected dental caries diagnostic and management methods.

J Dent Educ. 2001 Oct;65(10):960-8

Authors: Bader JD, Shugars DA, Bonito AJ

A systematic review of the English-language literature was conducted to address three related questions concerning the diagnosis and management of dental caries: a) the performance (sensitivity, specificity) of currently available diagnostic methods for carious lesions, b) the efficacy of approaches to the management of noncavitated or initial carious lesions, and c) the efficacy of preventive methods among individuals who have experienced or are expected to experience elevated incidence of carious lesions. From 1,328 caries diagnostic and 1,435 caries management reports originally identified, thirty-nine diagnostic studies and twenty-seven management studies were included in the final evidence tables. Point estimates or reasonable range estimates for the diagnostic validity of methods for the diagnosis of carious lesions could not be established from the literature reviewed. There are insufficient numbers of reports of diagnostic performance involving primary teeth, anterior teeth, and root surfaces. For posterior occlusal and proximal surfaces, quality issues and the variation among studies precludes establishing such estimates. The apparent differences in sensitivity among methods are generally smaller than the variation reported within methods. The literature on the management of noncavitated carious lesions consisted of five studies describing seven experimental interventions. Because these interventions varied extensively in terms of management methods tested as well as other study characteristics, no conclusions about the efficacy of these methods were possible. The literature on the management of individuals at elevated risk of carious lesions consisted of twenty-two studies describing twenty-nine experimental interventions. The strength of the evidence for the efficacy of fluoride varnish for prevention of dental caries in high-risk subjects was fair, and the evidence for all other methods was incomplete. Because the evidence for efficacy for some methods, including chlorhexidine, sucrose-free gum, and combined chlorhexidine-fluoride methods, is suggestive but not conclusive, these interventions represent fruitful areas for further research.

PMID: 11699997 [PubMed - indexed for MEDLINE]

Digital imaging modalities for dental practice.

Bull Tokyo Dent Coll. 2001 Feb;42(1):1-14

Authors: Wakoh M, Kuroyanagi K

The introduction of the computed tomograph in the 1970s revolutionized medical diagnosis by initiating the transition from analogue to digital imaging. During this period, more specialized equipment for image processing was developed, such as cathode-ray tubes for image display, special sensors for image acquisition, and storage devices for image archiving. Digital imaging systems designed exclusively for use in dentistry were developed in the latter half of the 1980s. Some are now being clinically applied under conditions of close scrutiny to determine diagnostic accuracy, image quality, and radiation exposure to patients. This article reviews the enabling technologies of digital systems used in dentistry, and focuses upon intraoral digital imaging systems, concepts for digital image acquisition, and variations in radiation dose and their effects on diagnostic accuracy of caries detection.

PMID: 11484791 [PubMed - indexed for MEDLINE]

Dental CT imaging: a look at the jaw.

Radiology. 2001 May;219(2):334-45

Authors: Abrahams JJ

The jaw comprises two complex bony structures: the mandible and maxilla. Their curved or archlike configuration makes radiographic imaging difficult. Furthermore, the superimposition of dense teeth and roots may obscure underlying tissues, and streak artifacts from dental restorations often degrade computed tomographic (CT) images. Recently, dental CT reformatting programs that use thin transverse images of the jaw to reformat multiple panoramic and cross-sectional views were developed. Since images are reformatted, streak artifacts that degrade bone visualization at direct coronal CT are projected over the crowns of the teeth, permitting optimal viewing of bone. As a result, these programs have been successfully used to evaluate implants, cysts, tumors, and surgical procedures. They have created not only a new modality for viewing the jaw but also a new partnership between dentists and radiologists. Questions that cannot be answered in the dentist's office with conventional radiographs are now answered in radiology departments with dental CT scans. The objective of this article is to trace, with a series of examples, the effect that this imaging modality has had on radiographic evaluation of the jaw and to provide the reader with knowledge that should enable him or her to become more involved in imaging of the jaw.

PMID: 11323454 [PubMed - indexed for MEDLINE]

Radiographic determinants of implant performance.

Adv Dent Res. 1999 Jun;13:136-45

Authors: Reddy MS, Wang IC

This paper reviews and compares the strengths and weaknesses of radiographic techniques including periapical, occlusal, panoramic, direct digital, motion tomography, and computed tomography. Practical considerations for each method, including availability and accessibility, are discussed. To date, digital subtraction radiography is the most versatile and sensitive method for measuring boss loss. It can detect both bone height and bone mass changes on root-form or blade-form dental implants. Criteria for implant success have changed substantially over the past two decades. In clinical trials of dental implants, the outcomes require certain radiographic analyses to address the hypothesis or clinical question adequately. Radiographic methods best suited to the objective assessment of implant performance and hypothesis were reviewed.

PMID: 11276736 [PubMed - indexed for MEDLINE]

Assessing the effectiveness of direct digital radiography barrier sheaths and finger cots.

J Am Dent Assoc. 2000 Apr;131(4):463-7

Authors: Hokett SD, Honey JR, Ruiz F, Baisden MK, Hoen MM

BACKGROUND: Effective cross-contamination prevention is critical for direct digital radiography, or DDR, sensors, which are not sterilizable; however, current manufacturers' recommendations for standard precautions are limited to the use of plastic barrier sheaths, which are commonly known to tear or leak. The authors sought to determine the incidence of digital radiography barrier-sheath leakage, with and without additional latex finger cot protection, as measured by a water pressure test. METHODS: Four hundred plastic barrier sheaths were randomly assigned to four groups based on intraoral radiograph positioning device use and supplemental barrier protection with a latex finger cot. Sheaths were carefully placed to cover DDR sensors for a single intraoral use, gently removed from the sensors and tested for leakage through a water pressure technique. RESULTS: Perforations occurred in 44 to 51 percent of plastic sheaths after a single radiographic exposure. However, only up to 6 percent of the plastic sheaths that were covered by a latex finger cot leaked during the water pressure test. CONCLUSIONS: At least 44 percent of the plastic barrier sheaths leaked after a single intraoral radiographic exposure. Use of a latex finger cot over the plastic sheath significantly reduced leakage to no more than 6 percent. CLINICAL IMPLICATIONS: Latex finger cots used in conjunction with the standard plastic sheaths that cover DDR sensors may more effectively prevent cross-contamination than do plastic sheaths alone. Dentists who use DDR sensors during highly invasive dental procedures such as dental implant surgery are encouraged to consider supplemental barrier protection for these delicate, expensive and nonsterilizable sensors to prevent patient cross-contamination.

PMID: 10770008 [PubMed - indexed for MEDLINE]

Long-term follow-up of maxillary incisors with severe apical root resorption.

Eur J Orthod. 2000 Feb;22(1):85-92

Authors: Levander E, Malmgren O

The purpose of the study was to analyse the mobility of teeth with severe orthodontically induced root resorption, at follow-up several years after active treatment, and to evaluate mobility in relation to root length and alveolar bone support. Seventy-three maxillary incisors were examined in 20 patients, 10-15 years after active treatment in 13 patients (age 24-32 years) and 5-10 years after active treatment in seven patients (age 20-25 years). All had worn fixed or removable retainers; seven still had bonded twistflex retainers. Total root length and intra-alveolar root length were measured on intra-oral radiographs. Tooth mobility was assessed clinically according to Miller's Index (0-4) and the Periotest method. Crestal alveolar bone level, periodontal pocket depth, gingival, and plaque indices, occlusal contacts during occlusion and function, and dental wear were recorded. There was a significant correlation (P < 0.05) between tooth mobility, and total root length and intra-alveolar root length. No correlation was found between tooth mobility and retention with twistflex retainers. None of the variables for assessment of periodontal status, occlusion and function were related to total root length or tooth mobility. It is concluded that there is a risk of tooth mobility in a maxillary incisor that undergoes severe root resorption during orthodontic treatment, if the remaining total root length is < or = 9 mm. The risk is less if the remaining root length is > 9 mm. Follow-up of teeth with severe orthodontically induced root resorption is indicated.

PMID: 10721249 [PubMed - indexed for MEDLINE]

Fraud the old-fashioned way.

J Am Dent Assoc. 2000 Mar;131(3):290

Authors: Bolin KA

PMID: 10715917 [PubMed - indexed for MEDLINE]

Digital radiographs.

J Am Dent Assoc. 2000 Jan;131(1):18, 20

Authors: Wadkins P

PMID: 10649866 [PubMed - indexed for MEDLINE]

The potential of digital dental radiography in recording the adductor sesamoid and the MP3 stages.

Br J Orthod. 1999 Dec;26(4):291-4

Authors: Abdel-Kader HM

The current study was undertaken to evaluate the reliability of using a recent advance in clinical radiographic technique, digital dental radiography, in recording two growth indicators: the adductor sesamoid and MP3 stages. With an exposure time five times less than that used in the conventional approach, this method shows greatest flexibility in providing a high quality digitized radiographic images of the two growth indicators under investigation. Refereed Paper

PMID: 10592156 [PubMed - indexed for MEDLINE]

Potential for fraudulent use of digital radiography.

J Am Dent Assoc. 1999 Sep;130(9):1325-9

Authors: Tsang A, Sweet D, Wood RE

BACKGROUND: Digital radiographic images can be manipulated using personal computers. To test the potential for fraudulent use, the authors altered a series of dental radiographs, printed them to simulate duplicated films and submitted them for authorization of proposed treatment. MATERIALS AND METHODS: The authors obtained periapical radiographs of teeth that contained small restorations or were unrestored from the files of three dental patients at a private dental practice. The authors used a flatbed scanner to digitize and import the radiographs into a computer. Then they added dental caries, large restorations, fractures and periapical pathosis to the radiographs. The authors proposed to the insurance companies that the teeth in question be restored using expensive treatment, such as root-canal therapy and full-coverage crowns. RESULTS: In each case, the insurance companies authorized the proposed treatment based on the appearance of the teeth on the radiographs. The altered images illustrated an apparent need for dental treatment that was not required and that could have led to payment for treatment that was not actually performed. CONCLUSIONS: This study illustrates the potential for the fraudulent use of manipulated digital radiographic images. CLINICAL IMPLICATIONS: Dentistry should be aware of the implications of the potential for such abuse and should develop measures both to prevent it from occurring and to facilitate its detection.

PMID: 10492539 [PubMed - indexed for MEDLINE]

Digital subtraction radiography: then (1983) and now (1998).

J Dent Res. 1999 Jan;78(1):7-10

Authors: Hausmann E

PMID: 10065940 [PubMed - indexed for MEDLINE]