Abstract
Aims: To satisfy the newly reverse modified intra-oral periapical projection, in order to reduce the pa-tient discomfort and eliminate gagging reflex during periapical radiography of the lower posterior teeth. Materials and methods: Twenty voluntaries patients have been used in this research aged between 20-25 years, each patient subjected for two intra-oral periapical radiographic examinations for lower posterior teeth (premolars and molars). The first radiographic exami-nation has been made with ordinary principles of intra-oral periapical radiographic projec-tion, while the second radiograph has been made with reverse modified principles of intra-oral periapical radiographic projection. Five independent examiners (two oral radiographer, oral surgeon, oral diagnosis and oral medicine), rated the two radiographic images obtained from both radiographic examination methods. Image quality was assessed by rating the visi-bility of five anatomical landmarks: tooth structures identification (enamel, dentin and root can-al system), bone trabiculation, mental foramen borders, inferior dental canal borders and lamina du-ra. Results: The data collected from the evaluation of the radiographic images obtained from both radiographic projections were analyzed by paired samples chi-square test, which shown no significant difference (P>0.05) in image quality obtained from both techniques for five selected structures. The bone trabeculae and the lamina dura given higher rating of total score with ordinary technique (54, 49 points respectively) when compared with reverse radi-ographic technique (47, 41 points respectively). The highest percentage of unrecognized shadow of mental foramen and the inferior dental canal with use of ordinary radiographic technique (40%, 30% respectively), while the other examined anatomic structures (tooth structure, bone trabeculae and lamina dura) can be identified clearly with both radiographic techniques. Higher percentage of gag reflex and pain discomfort was observed with ordinary technique projection (45%, 40% respectively) in comparison with reverse technique projec-tion (0%, 5% respectively). Conclusion: the reverse intra-oral periapical radiographic technique can be used accurately in the radiographic projection of the mandibular posterior teeth; with minimal pain discomforted and with eliminated gagging reflex initiation.
Highlights
Periapical radiography describes intraoral techniques designed to show individual teeth and the tissues around the www.rafidaindentj.netJameel NG apices
The data collected from the evaluation of the radiographic images obtained from both radiographic projections by the five examiners, were analyzed by paired samples chi-square test with Excel-Microsoft stastical software program, which showed no significant difference (P>0.05) in image quality obtained from both techniques for five selected structures (Table 1)
The total number and percentage of unidentified anatomical structures marked in the radiographic image obtained from each projection modalities are shown in the (Table 3), where the highest percentage of unrecognized shadow of mental foramen and the inferior dental canal was with the use of ordinary radiographic technique (40%, 30% respectively), while the other examined anatomic structures can be identified clearly with both radiographic techniques
Summary
Periapical radiography describes intraoral techniques designed to show individual teeth and the tissues around the www.rafidaindentj.netJameel NG apices. Periapical radiography describes intraoral techniques designed to show individual teeth and the tissues around the www.rafidaindentj.net. Each film usually shows two to four teeth and provides detailed information about the teeth and the surrounding alveolar bone (1). Intraoral radiography could be performed by either the bisecting-angle or the paralleling technique (2). Periapical radiography is not always as straight forward in practice as it appears in theory. Knowledge of the theoretical requirements of imaging enables the clinician to modify the available techniques to suit individual needs of patients (1). The high muscle attachments in the floor of the mouth on the lingual surface of the mandible sometime make it almost impossible to insert a film deep enough and sufficiently far toward the midline to record the entire examined tooth and the surrounding tissues, including the inferior dental canal. The high muscle attachments in the floor of the mouth on the lingual surface of the mandible sometime make it almost impossible to insert a film deep enough and sufficiently far toward the midline to record the entire examined tooth and the surrounding tissues, including the inferior dental canal. (1, 3)
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