Conventional Intraoral Radiography Research Articles

Comparing the Diagnostic Accuracy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in Identifying Interdental Bone Loss: An Observational Study

ABSTRACT The evaluation of conventional two-dimensional radiography is crucial in making the diagnosis of periodontitis. Radio-visiography (RVG) is one of the digital imaging modalities that have received significant recognition as a replacement for film-based radiography due to its improved image quality, quick turnaround time, and minimal radiation dose. In order to compare the diagnostic efficacy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in identifying Interdental Bone Loss, the present investigation was carried out. A cross-sectional observational study was conducted among 96 patients prospectively. Radiographs were exposed using a Gendex Oralix AC machine. Statistical data was analyzed using IBM SPSS statistical software using appropriate statistical tests. For both age categories, the radiographic method yielded a higher mean score than the periodontal probe method. The mean scores were noted to be higher following surgery. The radiographic approach recorded a greater mean score when gender groups were compared than the periodontal probe, which had a lower mean score. The mean scores after surgery were noted to be lower than the radiography approach and higher than the periodontal probe. The results demonstrate the radiographic technique’s significant advantage over clinical tests in determining furcation regions as well as its superior accuracy in spotting periodontal disintegration over clinical probing.

In Vitro Comparison of Three Dimensional Cone Beamed Dental Tomography with Intraoral Radiography in Detection of Dental Tomography with Intraoral Radiography in Detection of Dental Root Factures Root Factures

The precise diagnosis of dental root fractures in clinical practice is quite difficult. The aim of this study is to compare the results of three dimensional cone beam computed tomography (CBCT) and conventional intraoral radiography images in the diagnosis of dental root fractures. 50 maxillar central teeth with healthy roots were shot in a single blow in laboratory environment for cracks were studied for 10 teeth and horizontal root fractures created for 40 teeth. Parts of root fractures were sticked together by forming root fractures in five groups as crack, fracture without gap and fracture with 0,2 mm, 0,4 mm and 0,6 mm gaps. Images of all teeth were taken with CBCT and conventional intraoral radiography. Accurate diagnosis averages and positive predictive value test calculated through the data taken from the evaluation results of 30 dentists. Generally the results showed that images taken by the CBCT are better than images taken by the periapical radiography which obtained with traditional methods for the diagnosis of root fractures and cracks. The results also showed that the quality of the images increased as the voxel of the CBCT images decreased. It is shown that images taken by the CBCT provides better and clearer than the images taken by the traditional intraoral radiography in order to diagnose root fractures and cracks.

Assessment of linear measurements with intra oral grid on intra oral periapical image – A comparison of digital and conventional film images using bisecting angle and paralleling techniques

Background: The success of various treatments protocols depends on pre-operative diagnostic aids such as radiographic assessment with linear measurements, in such scenario radiographic grid with its unique design aids like a scale for image analysis on intraoral periapical radiograph. Hence, the intra oral grid is a simple and accurate way of measuring objects, and another advantage is to overcome various magnification errors associated with measurements. So, the present study was designed to know its accuracy in assessing the linear measurements. Materials and Method: The study sample comprised a total of 40 subjects, which were categorized into four groups. A total of 240 exposures were taken, where each patient was subjected to six radiographs, of which two are conventional intraoral periapical radiographs without grid, and two are conventional intraoral periapical radiographs with grid by bisecting and paralleling technique and another two radiographs are taken by digital CMOS sensor with intraoral periapical grid in all four groups. The measurements were performed on the radiographs using scale and divider and in case of radiograph with the grid by counting the grid lines from specific points. Results: The results of the study revealed on comparison of conventional and digital radiographs with and without a grid in both bisecting and paralleling technique in all the four groups, there was a statistically significant difference noticed with digital radiography compared to the conventional method in assessing the measurements with the grid with P value

Accuracy of Periapical Radiography and CBCT in Endodontic Evaluation.

Introduction A radiological evaluation is essential in endodontics, for diagnostic purposes, planning and execution of the treatment, and evaluation of the success of therapy. The periapical radiography is nowadays the main radiographic investigations used but presents some limits as 3D anatomic alteration, geometric compression, and possible anatomical structures overlapping that can obscure the area of interest. CBCT (cone beam computed tomography) in endodontics allows a detailed assessment of the teeth and surrounding alveolar anatomy for endodontic diagnosis, treatment planning, and follow-up. Objective The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures. Materials and Methods Statistical analysis was performed on 101 patients with previous endodontic treatments with the relative radiographic documentation (preoperative, postoperative, and follow-up intraoral X-ray) that had underwent at CBCT screening for surgical reasons. The CBCT scans were evaluated independently by two operators and compared with the corresponding periapical images. Results Our analysis shows that the two radiological investigations statistically agree in 100% of cases in the group of patients without any endodontic sign. In the group of patients with an endodontic pathology, detected with CBCT, endodontic under extended treatments (30.6%), MB2 canals in nontreated maxillary molars (20.7%), second canals in nontreated mandibular incisors (9%), root fractures (2.7%), and root resorption (2.7%) were not always visible in intraoral X-ray. Otherwise, positivity in the intraoral X-ray was always confirmed in CBCT. A radiolucent area was detected in CBCT exam in 46%, while the intraoral X-ray exam was positive only in 18%. Conclusions Our study shows that some important radiological signs acquired using CBCT are not always visible in periapical X-ray. Furthermore, CBCT is considered as a II level exam and could be used to solve diagnostic questions, essential to a proper management of the endodontic problems.

Comparison between direct digital and conventional intraoral radiographs in detecting alveolar bone lose in Iraqi male cigarette smokers

The role of smoking in periodontal disease has been extensively studied for many years. Many studies build up an increasing amount of scientific data which support the concept that tobacco use is an important risk factor for increasing of periodontal diseases.Intraoral radiographs are important for diagnosis of periodontal problems. The aim of this study is to estimate bone loss by using direct digital and conventional radiographs in smokers. One hundred eighty sites (for molar region except third molar) in cigarette smoking patients were examined by digital and conventional periapical radiograph for detection of alveolar bone loss according to sextants and severity of bone loss. All images were examined by measuring mesial and distal bone loss of molars. The study shows that the differences between the conventional and the digital images in estimation of alveolar bone loss were not the same in all mouth sextants, so more bone loss was indicated by digital image in the mandibular right and left sextants than conventional image while there was little differences in maxillary right and left sextants in both images. Also this study shows those highly significant differences in digital image than the conventional image in early bone loss but no significant differences in both moderate and severs bone loss.

Performance of cone beam computed tomography and conventional intraoral radiographs in detecting interproximal alveolar bone lesions: a study in pig mandibles

BackgroundCone beam computed tomography (CBCT) has been largely used in dentistry. Nevertheless, there is lack of evidence regarding CBCT accuracy in the diagnosis of early periodontal lesions as well as the correlation between accuracy and lesion size. The aim of this study was to evaluate accuracy of CBCT and conventional intraoral radiographs in detecting different-sized interproximal bone lesions created in pig mandibles. The hypothesis was that CBCT accuracy would be superior to radiographs in detecting incipient bone lesions.MethodsTwenty swine dry mandibles were used, totalizing 80 experimental sites. Four groups were created according to exposure time to perchloric acid 70–72%: controls (no exposure), 2-hour exposure, 4-hour exposure, and 6-hour exposure. Standardized CBCT and conventional intraoral radiographs were taken and analyzed by two trained radiologists. The presence of lesions in the dry mandible was considered the gold standard. Sensitivity, specificity, and accuracy in detecting different-sized bone lesions were calculated for CBCT and intraoral radiographs.ResultsAccuracy of CBCT ranged from 0.762 to 0.825 and accuracy of periapical radiography ranged from 0.700 to 0.813, according to examiner and time of acid exposure. Inter-examiner agreement varied from slight to fair, whereas intra-examiner agreement varied from moderate to substantial.ConclusionsCBCT performance was not superior to that provided by conventional intraoral radiographs in the detection of interproximal bone loss.

Comparison of clinical values between cone beam computed tomography and conventional intraoral radiography in periodontal and infrabony defect assessment

The use of CBCT for periodontal diagnosis and treatment plan is limited. The aim of this study is to compare the assessment of periodontal conditions and infrabony defects between conventional intraoral radiography (IOR) and CBCT. The study included 25 subjects who had periodontitis and at least two infrabony defects. All subjects received clinical periodontal examination, IOR and CBCT. Three periodontists assigned periodontal diagnosis and prognosis of each tooth. For teeth with infrabony defects, the number of defect walls and treatment was determined. IOR and CBCT assessment was compared. There were 666 teeth and 123 infrabony defects. The overall concordance between IOR and CBCT for periodontal diagnosis, prognosis, infrabony defect type and infrabony defect treatment were 79.3%, 69.5%, 44.7% and 64.2%, respectively. IOR underestimated diagnosis, prognosis and the number of infrabony defect walls at 16.4%, 24% and 37.4%, respectively. IOR and CBCT had poor concordance for periodontal regeneration (43.3%). Tooth extraction was more prevalent when assessed by CBCT (35.0% vs 22.7%). CBCT had excellent interexaminer agreement (Fleiss' kappa 0.87-0.94) and higher percentage of complete agreement among examiners than IOR for all assessments. IOR underestimated the severity and prognosis of periodontal disease. CBCT was superior to IOR for evaluation of infrabony defect morphology and treatment. CBCT provides excellent agreement among examiners on periodontal and infrabony defect assessment.

Comparison of Cone-Beam Computed Tomography and Intraoral Radiography in Detection of Recurrent Caries under Composite Restorations.

Secondary caries is the most common cause of dental restoration failures. This study aimed to compare the diagnostic accuracy of conventional and digital intraoral radiography and cone beam computed tomography (CBCT) for detection of recurrent caries around composite restorations. mesio-occluso-distal (MOD) cavities were prepared using bur on 45 extracted sound human molar teeth. The teeth were divided into 3 groups. In the control group, cavities were restored with composite resin after etching and bonding (n=15). In Group 2, 500-μm thick wax was placed over the buccal, lingual and gingival walls and the cavities were restored with composite resin. Group 3 specimens were subjected to pH cycling and artificial caries were created on the buccal, lingual and gingival walls. The cavities were restored with composite. Conventional and digital photo-stimulable phosphor (PSP; Optime) radiographs and two CBCTs images (NewTom 3G and Cranex 3D) were obtained from them. Presence or absence of caries in the cavity walls was assessed on these images. Data were analyzed using Kappa statistic. The diagnostic accuracy of CBCT was significantly higher than that of digital and conventional intraoral radiography (p<0.05). The accuracy was 0.83, 0.78, 0.55 and 0.49 for CBCT Cranex 3D, CBCT NewTom 3G, conventional and digital intraoral radiography, respectively. CBCT has a higher diagnostic accuracy than digital and conventional intraoral radiography for detection of secondary caries around composite restorations.

Cone Beam Computed Tomography Used in the Assessment of the Alveolar Bone in Periodontitis

Objectives: The aim of our study was to highlight the advantages of using Cone Beam Computed Tomography in the study of the extent of the alveolar bone loss, compared to the conventional intraoral radiography and to prove the boon of the CBCT scans for establishing the correct periodontal diagnosis. Material and methods: A total of 16 patients with age between 35-55 years old, and a minimum of 8 teeth per dental arcade, presenting peridontal clinical symptomatology were selected. We used a custom periodontal chart that included the measuring of the gingival recession and the pocket depth in 6 points for 16 teeth, 8 maxillary teeth and 8 mandibulary teeth in all cases. For the radiographic evaluation we used CBCT imaging and intraoral radiography. Results: CBCT scans offers the possibilities of measuring with accuracy the alveolar bone loss on mesial, distal vestibular and oral sides. It provides images with the exact position of the bone and also the expediency to assess the correct diagnosis. Retroalveolar radiography offers just a hint of the possible position of the alveaolar bone in all cases the anatomical details were offered by CBCT. Conclusions: A correct periodontal diagnosis using conventional radiography is not possible because of the superimposition of the anatomical structures. The importance of CBCT imaging is no longer disputed, at the present time it is the best radiographic investigation available.

Comparing the Accuracy of Cone Beam Computed Tomography,Digital Intraoral Radiography and Conventional Intraoral Radiography in the Measurement of Periodontal Bone Defects

Comparing the Accuracy of Cone Beam Computed Tomography,Digital Intraoral Radiography and Conventional Intraoral Radiography in the Measurement of Periodontal Bone Defects

Detection of root perforations using conventional and digital intraoral radiography, multidetector computed tomography and cone beam computed tomography.

ObjectivesThis study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth.Materials and MethodsMesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test.ResultsThe sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed.ConclusionsIf it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended.

A comparative study of the conventional and digital intraoral radiography methods for root canal length measurement

Objective: Measurement of root canal length is one of the most important stages of endodentic treatment, and any error at this stage can lead to the failure. This study aimed to compare conventional and digital intraoral radiography in measurement of root canal length. Material and Methods: In this study, 35 single-canal maxillary teeth were collected. Access cavities were prepared. An endodontic number 10#K- file was introduced into the canal, until the tip was visible at the apical foramen and the actual canal length (gold standard) was determined. After acquisition conventional radiographs using E-Ektaspeed and F-Insight film (Eastman-Kodak Co. Rochester, NY, USA) and digital radiographs using Photostimulable Phosphor Plates(PSP) (Soredex, Helsinki, Finland) and Charge Coupled Devices (CCD)(RVG, Trophy,NY,USA). they were examined separately with a two-week interval by two oral and maxillofacial radiologists. The data were analyzed with ANOVA and Tukey’s tests using SPSS-19 software (SPSS Inc., Chicago, IL, USA). Result: No statistically significant difference was observed between different radiographies, and different observers (P &gt; 0.05). Nevertheless, in comparison with the gold standard, in all cases, the F-speed conventional radiography and the digital CCD radiography showed the highest and the lowest accuracy, respectively. Also, the PSP and the E-speed conventional radiography were in the second and third order of accuracy, respectively. Conclusion: The use of digital radiography does not improve the accuracy of the root canal length measurement,but the digital technique has advantages,such as the reduced patient exposure ,eliminating the time consuming processing stages, and producing fast images.

Accuracy of conventional and digital radiography in detecting external root resorption.

External root resorption (ERR) is associated with physiological and pathological dissolution of mineralized tissues by clastic cells and radiography is one of the most important methods in its diagnosis. The aim of this experimental study was to evaluate the accuracy of conventional intraoral radiography (CR) in comparison with digital radiographic techniques, i.e. charge-coupled device (CCD) and photo-stimulable phosphor (PSP) sensors, in detection of ERR. This study was performed on 80 extracted human mandibular premolars. After taking separate initial periapical radiographs with CR technique, CCD and PSP sensors, the artificial defects resembling ERR with variable sizes were created in apical half of the mesial, distal and buccal surfaces of the teeth. Ten teeth were used as control samples without any resorption. The radiographs were then repeated with 2 different exposure times and the images were observed by 3 observers. Data were analyzed using SPSS version 17 and chi-squared and Cohen's Kappa tests with 95% confidence interval (CI=95%). The CCD had the highest percentage of correct assessment compared to the CR and PSP sensors, although the difference was not significant (P=0.39). It was shown that the higher dosage of radiation increases the accuracy of diagnosis; however, it was only significant for CCD sensor (P=0.02). Also, the accuracy of diagnosis increased with the increase in the size of lesion (P=0.001). Statistically significant difference was not observed for accurate detection of ERR by conventional and digital radiographic techniques.

Cone beam computed tomography for the diagnosis of vertical root fractures: a systematic review of the literature and meta-analysis

The aim of this review was to compare the efficiency of cone beam computed tomography (CBCT) and conventional intraoral radiography for the detection of vertical root fractures (VRFs). Data from comparative and noncomparative studies investigating CBCT, conventional radiography, or both for the diagnosis of VRFs were searched. The main outcome variables were sensitivity, specificity, and accuracy of the techniques. Data were separated into 4 groups: in vivo, ex vivo/untreated teeth, ex vivo/treated teeth, and ex vivo with post. The weighted mean of each parameter was estimated. Twelve articles were considered for the analysis. There was a large heterogeneity of the characteristics of the studies and a wide variability in outcome variables. No significant differences were found between radiographic techniques. No superiority of CBCT compared with conventional radiography was found for VRF detection. Adequate choice of voxel size seems to be important when diagnosing VRFs.

Imaging of occlusal dentine caries: a comparison among conventional radiographs, digital radiographs, and cone-beam computed tomography images

To compare conventional radiographs, digital radiographs, equalized images of digital radiographs, and cone-beam computed tomography (CBCT) images for in vitro imaging of occlusal dentine caries. A total of 160 extracted human posterior teeth were evaluated in the study. All teeth were free of restorations and proximal caries. The clinical appearances of the occlusal surfaces of the teeth ranged from sound to discolored, with no macroscopic cavitation. Conventional intraoral radiographs, digital intraoral radiographs, and CBCT images of the teeth were taken. The images were evaluated independently by three observers for the presence of occlusal dentine caries. The teeth were then sectioned and computerized images were obtained for the histological sections using a digital camera linked to a stereomicroscope at 10× magnification. The histological images were assessed for the presence or absence of dentinal caries. The sensitivity, specificity, accuracy, and area under the receiver-operating characteristic curve (Az value) were calculated for each diagnostic method. Sensitivity was greatest for CBCT images (mean = 0.63) and lowest for digital radiographs (mean = 0.38). Specificity was greatest for digital radiographs (mean = 0.76) and lowest for CBCT images (mean = 0.64). The mean Az values ranged from 0.56 to 0.60 (P > 0.05). The interobserver and intraobserver agreements were greatest for CBCT images (mean kappa = 0.66 and 0.73, respectively). There were no differences in the accuracy of detection of non-cavitated occlusal dentine caries among the diagnostic modalities used. Cone-beam computed tomography images were more sensitive, while digital radiographs were more specific.

Comparison of the accuracy of cone-beam computed tomography, photostimulable phosphor imaging plate, charge coupled device, and conventional intraoral radiography in the diagnosis of internal root resorption: an in vitro study

Objective: Various radiographic methods are used to identify the internal root resorption. The aim of this study was to assess and compare the diagnostic accuracy of cone-beam computed tomography (CBCT), photostimulable phosphor (PSP) imaging plate, charge coupled device (CCD), and conventional intraoral radiography (CIR), for internal root resorption.Methods: This experimental study was conducted in Hamadan in 2012. Fifty seven carries-free anterior teeth were divided into three intervention groups of 15 teeth and one control group of 12 teeth. Teeth were split into two parts using a disk. Cavities of 0.5, 1 and 1.5 mm in depth were created in root canal of teeth to simulate internal root resorption artificially. Finally, the teeth fragments were fused. All teeth were examined with four different procedures and the results were compared with known simulated internal root resorption as the gold standard to determine the sensitivity and specificity of the procedures.Results: The sensitivity of CBCT, PSP, CCD, and CIR for diagnosis internal root resorption of 0.5 mm in depth was 93%, 73%, 60%, and 53% respectively. The sensitivity of all four procedures for diagnosis of internal root resorption with 1 and 1.5 mm in depth was the same and equal to 100%. Specificity of the four radiology procedures for diagnosis of internal root resorption of any depth was 100%, 100%, 83% and 75% respectively.Conclusion: CBCT provides the most accurate information on the depth and location of root resorption followed by the PSP and CCD respectively. Accordingly, conventional intraoral radiography was the least accurate procedure.

Diagnostic Applications of Cone-Beam CT for Periodontal Diseases.

Objectives. This paper aims to review the diagnostic application of cone beam computed tomography (CBCT) in the field of periodontology. Data. Original articles that reported on the use of CBCT for periodontal disease diagnosis were included. Sources. MEDLINE (1990 to January 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “CBCT,” “volumetric CT,” “periodontal disease ,” and “periodontitis.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. Bony defects, caters, and furcation involvements seem to be better depicted on CBCT, whereas bone quality and periodontal ligament space scored better on conventional intraoral radiography. CBCT does not offer a significant advantage over conventional radiography for assessing the periodontal bone levels.

Management of a mandibular molar with C-shape root canal using spiral computed tomography as a diagnostic aid

The aim of this article is to present the use of spiral computed tomography (CT) in endodontic management of a mandibular molar with an unusual morphology of C-shape canal. An accurate assessment of this unusual morphology was made with the help of spiral CT. This report extends the range of known possible anatomical variations to include teeth with an abnormal number of roots and canals. This report also highlights the role of spiral CT, over conventional intra-oral periapical radiographs, as an objective method to confirm the three-dimensional anatomy of teeth.

Utility of extra-oral aiming device in imaging periapical regions of posterior teeth.

Intraoral film placement and the film holding equipments are not acceptable by many due to varied reasons. To evaluate the utility of extra-oral aiming device developed by Chia-hui chen for imaging the periapical regions of posterior teeth employing the technique suggested by saberi et al. The study subjects included 20 patients in the age group of 10-35 y. The subjects were further subdivided according to the area to be imaged into four groups, with 5 in each. Imaging was done using the device developed by chia-hui chen, with the method employed by newmann and saberi et al., The radiographs were then interpreted for complete coverage of the anatomical structure. The findings were recorded and subjected to Analysis of variance (ANOVA) statistical analysis. The visibility of imaging area was more in mandible (95%) than maxilla (86.5%). The overall accuracy was 90.75%. These findings were statistically non-significant (F- 2.152 & P-0.134). Among the reason for reduced accuracy, overlapping of the opposite arch (4%) was more common and the horizontal overlapping (0.5%) was least common. This technique is not meant to replace conventional intraoral radiography. It is a useful supplementary aid to our clinical practice.

Erupted odontomas: a report of two unusual cases

Odontomas are the most common odontogenic tumors of the jaws which are benign, slow growing and nonaggressive. They are usually asymptomatic and are diagnosed on routine radiological examination. The eruptions of odontomas are uncommon and very few cases are reported in the literature. Objective: To report two rare cases of erupted compound odontomas. Case report: Two cases of erupted compound odontomas are reported in middle aged patients. Erupted miniature teeth-like structure were seen on clinical examination. The condition was diagnosed on the basis of conventional intraoral radiographs and histopathological examination. Both cases were treated by surgical excision under local anaesthesia without any complications. Conclusion: Odontomas are benign tumors with uncertain etiology. Odontomas erupting in the oral cavity is an infrequent situation. Surgical excision is the treatment of choice in all such cases followed by histopathological examination to confirm the clinical diagnosis.