Conventional Radiographic Techniques Research Articles

The use of cone beam computed tomography in endodontic re-treatment

Radiography plays an integral role in endodontics. However, conventional radiographic techniques have limitations, such as background noise, providing only a two-dimensional representation of the image, superimposition and distortion. Cone beam computed tomography (CBCT) provides the clinician with a three-dimensional image of the structures involved in the clinical situation. When considering options for endodontic re-treatments, it is vital to identify the cause of the initial failure and here, the use of CBCT images can be beneficial. This is illustrated through an endodontic re-treatment case owing to a palatal canal missed with conventional radiographic techniques. CPD/Clinical Relevance: Cone beam computed tomography can be beneficial in cases of endodontic re-treatment.

Intraoperative CT for lumbar fusion is not associated with improved short- or long-term complication profiles

Background ContextThe use of intraoperative CT has continued to grow in recent years, as various techniques leverage the promise of improved instrumentation accuracy and the hope for decreased complications. Nonetheless, the literature regarding the short- and long-term complications associated with such techniques remains scant and/or confounded by indication and selection bias. PurposeTo use causal inference techniques to determine whether intraoperative CT use is associated with an improved complication profile as compared to conventional radiography for single-level lumbar fusions, an increasingly commonplace application for this technology. Study Design/SettingInverse probability weighted retrospective cohort study carried out within a large integrated health care network. Patient SampleAdult patients who underwent surgical treatment of spondylolisthesis via lumbar fusion from January 2016 to December 2021. Outcome MeasuresOur primary outcome was the incidence rate of revision surgery. Our secondary outcome was the incidence of composite 90-day complications (deep and superficial surgical site infection, venous thromboembolic events, and unplanned readmissions). MethodsDemographics, intraoperative information, and postoperative complications were abstracted from electronic health records. A propensity score was developed utilizing a parsimonious model to account for covariate interaction with our primary predictor, intraoperative imaging technique. This propensity score was utilized in the creation of inverse probability weights to adjust for indication and selection bias. The rate of revisions within 3 years as well as the rate of revisions at any time-point were compared between cohorts using Cox regression analysis. The incidence of composite 90-day complications were compared using negative binomial regression. ResultsOur patient population consisted of 583 patients, with 132 who underwent intraoperative CT and 451 who underwent conventional radiographic techniques. There were no significant differences between cohorts following inverse probability weighting. No significant differences were detected in 3-year revision rates (HR, 0.74 [95% CI 0.29, 1.92]; p=.5), overall revision rates (HR, 0.54 [95% CI 0.20, 1.46]; p=.2), or 90-day complications (RC -0.24 [95% CI –1.35, 0.87]; p=.7). ConclusionsIntraoperative CT use was not associated with an improved complication profile in either the short- or long-term for patients undergoing single-level instrumented fusion. This observed clinical equipoise should be weighed against resource and radiation-related costs when considering intraoperative CT for low complexity fusions.

Comparative cone-beam computed tomographic evaluation of maxillary incisor intrusion and associated root resorption: Intrusion arch vs mini-implants

Various literature has verified that apical root resorption is a common adverse effect of orthodontic treatment, particularly intrusion. Conventional radiographic techniques underestimated root lengths and overestimated tooth lengths. Cone-beam computed tomography (CBCT) is a useful diagnostic tool to detect orthodontically induced external apical root resorption. This prospective study aimed to compare maxillary incisor intrusion and associated root resorption via CBCT. Thirty patients aged 16-23 years, having a deepbite of 6-8 mm and excessive gingival display on smiling, were divided into 2 groups: group 1, with 15 patients who were treated with Burstone intrusion arch, and group 2 with 15 patients who were treated with mini-implants applying 100 g of intrusive force for 4 months with activation done every 4 weeks. During this 4-month study period, no treatment was performed other than the intrusion of incisors. CBCT scans were obtained before and after the intrusion phase of treatment to compare the amount of intrusion and associated root resorption among both groups. No significant difference was found in mean incisor intrusion between groups 1 and 2 (P= 0.772), with slightly more proclination of incisors in group 1, resulting in a significant (P= 0.018) increase in the vertical change of incisal edge in group 1. A statistically significant difference was found in root resorption among both groups (P= 0.004), with more root resorption in group2. The results of this study indicate intrusion with both the intrusion systems using appropriate intrusive forces is effective in opening the bite with slightly more external apical root resorption in the mini-implant group.

Mylohyoid Ridge as a Predictor of Available Bone for Implant Placement: A Cone-Beam Computed Tomography (CBCT) Retrospective Observational Study.

Introduction: The posterior mandibular region, due to the presence of vital structures, poses a high risk during implant placement because of its susceptibility to neurovascular injury and perforation of the lingual cortex. A breach in implant length and available bone height may lead to serious intraoperative and postoperative complications. Prediction of the exact location of the inferior alveolar nerve and submandibular fossa anatomy is a prerequisite for ideal implant placement, which is always not possible with conventional radiographic and clinical techniques.Materials and methods: One hundred ten cone-beam computed tomographies (CBCTs) of patients were acquired from the radiological archives of a radiological center in Chennai. DICOM files from CBCT were exported to Bly Sky Plan software. Cross-sections of the second molar and first molar were extracted following the inclusion criteria. The linear dimension between the mandibular canal and mylohyoid ridge and anatomic variables of the submandibular fossa were measured digitally on the left and right sides using software measuring tools. Descriptive statistics were done. The unilateral and bilateral site and gender differences were evaluated. Bone height superior to the mandibular canal was correlated with the submandibular fossa parameters; depth of undercut in the vertical and horizontal directions; and angle of the undercut.Results: The mandibular canal was on average 5.5 mm and 4 mm inferior to the Mylohyoid ridge in the second molar region and first molar region, respectively, with the right and left sides showing no statistically significant difference. The depth of fossa undercut in vertical and horizontal dimensions was higher in the second molar region compared to the first molar region. The height of the deepest point of the undercut in the vertical dimensions showed a positive correlation with the bone available between the mandibular canal and the mylohyoid ridge.Conclusion: Keeping 2 mm of safety factor in consideration, implants can be safely placed up to the mylohyoid ridge in 100% of cases and 2 mm below the mylohyoid ridge in 78.9% of cases in the mandibular second molar region. In keeping with a safety factor of 2 mm, implants can be safely placed up to the mylohyoid ridge in 82.6% of cases and 2 mm below the mylohyoid ridge in 43.1% of cases in the first molar region. A more pronounced undercut was seen in the second molar region than in the first molar region. Deeper fossa undercuts in vertical dimension are associated with more inferior positioning of the mandibular canal.

English

This paper reports a fusion of the mandibular lateral incisor and a supernumerary tooth, case focuses on the diagnosis of the clinical and radiographic features. The clinical examination revealed the absence of interdental embrasure and unesthetic appearance of the right mandibular lateral incisor. The conventional radiograph did not reveal thorough information to decide on provisional and differential diagnosis as it provides a two-dimensional view, which is the main limitation of the conventional radiographic technique. The presence of fused tooth was confirmed by the newer technique CBCT which was very specific in reading the difference in morphology of the tooth, that was well appreciated.

Intraoral Radiographic Processing Skills among Dentists in Saudi Arabia

AIM: The present study was designed to investigate use of intraoral radiographic techniques (conventional and digital) among general dental practitioners (GDP) in Saudi Arabia with focus on its availability in workplace, ease of the technique, and the recommended technique to be taught during undergraduate based on individual experience. METHODS: A questioner in form of a Google sheet was designed concerning demographic data, country, district, university, year of graduation, availability of radiographic technique available in workplace, which technique learned during undergraduate study, and which technique should teach during undergraduate study based on individual experience. A GDP list was developed from different dental groups on social media. The questioner was sent to the GDP list and to improve the response rate, telephone calls were made in advance to all expected participants. RESULTS: About 62.2% of participants were graduated within past 5 years, the most common dental X-ray processing technique learned during undergraduate study was the digital and conventional (both theoretical and practical) in 47.6% of participants followed by conventional (theoretical and practical) technique in 21% participants. Based on their work experience, 74.8% of participants preferred both digital and conventional techniques should be taught in dental Saudi Universities/Colleges while, the digital method was preferred by 21%. CONCLUSION: However, intraoral digital radiographic technique is widely available in most regions in Saudi Arabia; it is recommended to teach both intraoral digital and conventional radiographic techniques during undergraduate study.

The difference in radiopacity of microhybrid, nanofiller and nanohybrid composite resins with conventional periapical radiographic techniques

Objective: The radiopacity of dental composite restorative materials is important since it allows assessment of the integrity of composite restorations, accurate diagnosis of secondary caries development and evaluation of the interface between the com-posite restorative material and the tooth structure on the new materials introduced in the market nowadays. The purpose of this observation is to determine the differences of microhybrid, nanofiller and nanohybrid composite resins on their radiopacity using conventional periapical radiography techniques. Methods: Composite resins samples were divided into three groups; 30 samples each. Group I were microhybrid composite resin. Group II were nanofiller composite resin. Group III were nanohybrid composite resin. Each specimen was placed on a dental film and exposed using conventional radiographic techniques with the specification of 70 kVp, 8mA and 0.25s, then processed using instant film procedures. Observations were carried out using the densitometer. The results of calculations were analyzed by using the one way Anova test. Results: Significant radiopacity dif-ferences were occurred in those three groups (p<0.05). Nanohybrid composite resin (2.32 mmAl) was significantly more ra-diopaque than microhybrid composite resin (2.20 mmAl) and nanofiller composite resin (2.10 mmAl). Conclusion: There are differences between microhybrid, nanofiller and nanohybrid composite resins. Resins that have the highest to the lowest ra-diopacity levels are nanohybrid, microhybrid, and nanofiller composite resin.

‘DENTIST’S PERSPECTIVE ABOUT RADIOLOGICAL WASTE MANAGEMENT’- A QUESTIONNAIRE STUDY IN TAMIL NADU

BACKGROUND: Radiographs are diagnostic aids commonly used by dentists and physicians for accurate diagnosis and proper treatment. Traditional method of radiography is still being practiced despite the invention and evolution of digitalization. Dental workplaces that practice conventional radiographic techniques must use numerous chemical solutions for X-ray film processing. All these chemical solutions necessitate specific handling and disposal techniques. OBJECTIVES: To evaluate the knowledge on dental radiological waste management among dentists in Tamil Nadu. METHODOLOGY:A survey was performed for a sample size of 379 dental clinicians. A multiple‑choice response type of questionnaire was designed with close‑ended questions with a maximum choice of four responses. Responses were evaluated to extract the results. RESULTS: The result of this present study showed that total correct answers have been reported to be <50%. This showed lack in knowledge among the dentists. CONCLUSIONS: Harmful dental radiographic wastes should be carefully disposed to minimize hazards to the environment. Although there is small amount of contribution of waste generated by individual, it’s eventual accumulation plays a pivotal role in affecting the environment and human health in various ways. Thus, it becomes exceedingly significant for proper disposal of waste products from conventional radiographs in lowering its impact on the surrounding environment. KEYWORDS: Radiographic waste, lead foil waste, silver waste.

Automatic Detection and Characterization of Weld Defects Using CNN Algorithm in Machine Learning

Conventional radiographic technique uses visual inspection of scanned output for defect detection. This makes the inline testing of products time consuming and hectic. Convolutional Neural Network (CNN) algorithm in machine learning can be used for the automation of defect detection in radiography thereby reducing human intervention and associated delays. By the use of robotics the welding parameters can be adjusted and the issue of welding defects can be resolved. By combining the two, the defect detection process can be modified into a digital manufacturing process. A dataset created from radiography test data is used for training the algorithm and for writing a program to train this dataset which can be used for defect detection and its characterization.

Diagnosis and Management of Traumatic Dental Injuries Using Intraoral Radiography and Cone-beam Computed Tomography: An In Vivo Investigation

The aim of this study was to compare periapical radiographs (PRs) and upper standard occlusal (USO) radiographs with cone-beam computed tomographic (CBCT) imaging on clinicians' confidence in the diagnosis and management of traumatic dental injuries (TDIs). This study included 35 maxillary anterior teeth from 25 patients with at least 1 PR (parallax view) and a CBCT scan. Fourteen patients also had a USO radiograph. Ten examiners selected a diagnosis and treatment plan, which were compared with a reference standard. Sensitivity, specificity, positive and negative predictor values, and receiver operating characteristic analysis were used to determine the diagnostic accuracy. CBCT imaging exhibited significantly higher sensitivity than both conventional radiographic techniques combined (PRs and PRs + USO radiographs) for all diagnoses (TDI: 99% vs 84%, lateral luxation: 80% vs 34%, extrusions: 92% vs 42%, and cortical plate fracture: 58% vs 1%) other than horizontal root fractures in which the results were close to statistical significance (88% vs 69%). CBCT imaging was significantly more accurate for all diagnoses (TDI: 91% vs 70%, lateral luxations: 83% vs 61%, extrusive luxations: 92% vs 68%, alveolar cortical plate fractures: 78% vs 48%, and horizontal root fractures: 93% vs 82%).Examiners had the most confidence with CBCT imaging and the least confidence in diagnosing using PRs + USO radiographs than with PRs alone. Agreement with management plans was significantly better using CBCT imaging compared with PRs and PRs + USO radiographs. CBCT imaging improved the clinical diagnosis of TDIs. The addition of USO radiographs to PRs did not improve the diagnosis of TDIs in this investigation. CBCT imaging improved confidence in the diagnosis of TDI cases and treatment planning compared with conventional radiography.

The impact of cone beam computed tomography in diagnosis and endodontic treatment planning decisions - case reports

Conventional radiographic techniques have limitations, showing a two-dimensional image of a three-dimensional object, making it difficult to recognize the internal root anatomy in endo-dontic therapy. Cone-beam computed tomography (CBCT) is a diagnostic method that allows the visualization of all structures three-dimensionally, showing promising results compared to periapical radiographs. The objective of this study was to report two clinical cases where CBCT was fundamental to the diagnosis and a better treatment planning of the steps that were taken during the endodontic intervention. The CBCT were performed prior to the treat-ments, the volume of the exams were dynamically analyzed in specific software. The data were interpreted and together with the radiographic image and clinical examination data, the diagnosis and treatment planning were carried out. Given the report and discussion of the two clinical cases, it can be concluded that CBCT proved to be an impacting resource to support diagnosis and decision-making in the treatment of complex endodontic cases. CBCT ensured greater reliability in the diagnosis and treatment plan adopted, increasing the predictability of the endodontic therapy.

ROLE OF MAGNETIC RESONANCE IMAGING SIALOGRAPHY IN DIAGNOSIS OF SALIVARY GLAND DUCT DISEASES

Salivary gland duct diseases have been commonly addressed and investigated using ultrasound and conventional radiographic techniques. However, ultrasound assessment displays a limited view of the salivary ductal tree. While conventional X-ray or CT sialography may provide acceptable spatial anatomy, a number of drawbacks were reported, with complications such as trauma or acinar rupture and sepsis, and contraindications such as acute parotitis or contrast material allergy, not to mention the required high operator experience and patient compliance.MR sialography is a new nonionizing noninvasive technique that is being developed to evaluate diseases of the salivary ducts. Adequate assessment of the duct system is obtainable, with no involvement of invasive techniques, or contrast material or radiation exposure.MR sialography offers many advantages over alternative imaging techniques such as conventional x-ray sialography. These include the noninvasive technique; avoiding contrast media, ionizing radiation, and dependence on an experienced operator.Details provided by MRI sialography are considered to be of value for the interventional decision-making process. These details include the distance of the obstructing cause from the ductal punctum, the size and number of stones, ductal mapping and diameters, Upstream dilatation, and ductal condition.

Cost minimization of 3 methods of acquiring dental radiographic image

Abstract The objective of this study is to develop a complete economic evaluation of 3 diagnostic techniques for interproximal radiographic, comparing the conventional radiographic technique, direct (CMOS) and indirect (PSP) digital techniques in the diagnosis of dental caries, from the perspective of SESC/Brazil (Social Trade Service). A complete cost-minimization economic assessment was performed. Initially, a systematic review was performed and it was verified that the accuracy for the diagnosis is similar between the techniques. The direct medical costs (related to the technique) were estimated by the bottom-up technique, taking into account the value of the clinical hours of the professionals, equipments and materials used. The time horizon was 10 years. The values were discounted at 3% per year, and a sensitivity analysis was prepared into two scenarios (one more pessimistic with costs 20% higher than estimated and one more optimistic with costs 20% lower). Direct digital radiography proved to be the option with the lowest cost (US$ 1.16), followed by semi-direct (US$ 1.35) and conventional (US$ 1.47). Conventional radiography presented the highest cost for the period (US$ 74,943.65), and the use of digital radiographs could promote savings of US$ 6,000.59 and US$ 15,448.35, if used by the semi-direct and direct method. respectively. Regarding the sensitivity analysis, in the most optimistic scenario of the time horizon there would be savings of US$ 4,800.47 (semi-direct digital) to US$ 12,446.09 (direct digital) compared to the traditional technique (films). In the most pessimistic scenario, these values vary in savings over the time horizon from US$ 7,200.71 (semi-direct) to US$ 18,538.02 (direct). It is concluded that the direct radiographic technique was the most cost effective and its incorporation in the SESC units is suggested. Key messages Digital dental radiography. Cost minimization analysis. Health technology assessment.

Role of computed tomography scan in diagnosis of retroperitoneal masses

Background: In the vast and ever-expanding field of surgery there are only few subjects which have provoked controversy; curiosity related to correct management of patients suffering from various condition of the abdomen. This becomes very true when the patient has a retroperitoneal mass clinically. The problem of retroperitoneal mass was intriguing, fascinating and certainly most perplexing. The present study was planned with the objective to study the various clinical presentations of retroperitoneal mass, and their radiological findings, and co-relation between these various findings.Methods: This was a prospective, cross-sectional study. The study included 30 patients clinically diagnosed having retroperitoneal mass, attending the department of general surgery.Results: The most common affected age group was of 40-50 years (9, 30.00%). The most frequent presenting symptoms were abdominal lump (28, 93.33%). Pallor was the commonest clinical sign (20, 66.67%). Retroperitoneal lymph node masses were the commonest (12, 40.00%) malignant lesions. Retroperitoneal lymphadenopathy was the most common lesion.Conclusions: The retroperitoneum has long been an area poorly visualised by conventional radiographic techniques and in this respect, computed tomography scan has great advantages over other modalities. Hence the modern surgeon should no longer be considered a ‘shadow-gazer' but an anatomist in-vivo.

Mastoid and Magnum – Hidden Key in Forensics – A Retrospective Three-Dimensional Cone-Beam Computed Tomographic Study

Introduction and Aim: The identification of skeletal remains and decomposing them is the most challenging skill in medicolegal investigations. Gender determination utilizing the skeletal remains has been of keen interest. This study aims to assess the role of the foramen magnum (FM) and mastoids in gender determination through osteometric analysis using cone-beam computed tomography (CBCT). Materials and Methods: A retrospective analysis of the osteometric measurements in relation to FM (shape, length, width, and area) and mastoid process (length, width, height, angle, area, and intermastoid distance) was assessed in 60 CBCT images in Planmeca ProMax three-dimensional midface machine using Romexis software, taken for the purpose of various dental treatments in the Department of Oral Medicine and Radiology, Meenakshi Ammal Dental College, Chennai. Results: P Conclusion: Throughout history, dental forensics has played a major role in the identification of human remains. CBCT is gaining more popularity in the recent times over the other conventional radiographic techniques because of lesser radiation exposure, better accuracy thus it could widen the frontiers of forensics. With the emerging trends in forensics, this study will reveal the explicit aid of FM and the mastoid process using CBCT in forensic odontology.

A comparative observational study based on two radiographic techniques in suspected unilateral mandibular condylar fracture

Objective: This hypothetical comparative study aimed to compare two radiographic techniques based on the traditional radiograph (orthopantomography [OPG]) and computed tomography (CT) scans and find the best radiographic techniques to be used to confirm diagnostic accuracy and treatment planning in suspected unilateral condylar fractures. Materials and Methods: All patients with suspected unilateral condylar fractures were initially subjected to a radiologic assessment through a conventional radiographic technique of OPG to select the treatment modality, that is, open or closed. Subsequently, all patients were made to undergo a standard CT scan for the study of the temporomandibular joint, with the same objective, that is, (eighty radiographic imaging: forty OPG + forty CT scan) was done to determine which radiographic technique is more helpful in determining the final clinical diagnosis including treatment planning of suspected unilateral mandible condyle fracture. The findings were compared and cross-checked with those of conventional radiographic analysis. Results: It was found that out of the selected patients of confirmed forty unilateral condylar fractures, 33 patients were indicated for closed reduction by conventional radiography, were revealed to have a lateral extracapsular displacement on CT scan, and hence were treated by open reduction. Seven patients satisfied the criteria for closed reduction, both by conventional radiographs and CT scans. Conclusion: Through this theoretical research, it was found that both radiographic techniques are indispensable, specific, and standard in the detection of mandibular fractures. It was noted that CT scan radiographic information might help alter the approach and the treatment plan and prevent erroneous management in mandibular condylar fractures.

COMPARATIVE ASSESSMENT OF ULTRASONOGRAPHY (USG) AND CONVENTIONAL RADIOGRAPHY FOR REVEALING THE BONY FRACTURES IN ADULTS

Rapid developments in computing hardware and microelectronic technology have facilitated technological advancement in ultrasonography (USG) in the last 3 decades, making it applicable not only to soft-tissues, but also to bony lesions. This has increased interest in evaluating ultrasound imaging as an alternative to conventional radiography. Hence based on above literate findings the current study was planned to assess that comparative evaluation of the Ultrasonography and conventional radiography in the detection of the bone fracture in the patients referred to Department of Radiography.
 The study was planned by enrolling 25 patients identified as fracture cases. The patients were referred to the Department of Radiology in the Narayan Medical College and Hospital from May 2017 to Dec 2017 was enrolled in the present study. The patients were examined by the Ultra sonographic as well as conventional radiographic techniques. Open, unstable or suspected compound fractures, unstable patientswith deranged vitals and pregnant females were excluded from the present study.
 Ultrasonography is a very rapid, cost-effective, and radiation free imaging technique for detection of superficially situated bone fracture. Based on the findings of the present analysis, screening performance characteristic of ultrasonography in detection of fractures was found to be higher than radiography. USG can replace conventional radiography in cases of isolated uncomplicated fractures. In cases of doubtful fracture, combination of USG and conventional plain films may be considered to avoid unnecessary exposures from higher imaging like CT scan.
 Keywords: Ultrasonography, Conventional Radiography, Bony Fractures, USG, etc.

Comparison of conventional and digital radiographic techniques for the assessment of alveolar bone in periodontal disease

Background: Alveolar bone loss at the crest and interdental osseous defects are the frequent outcomes of periodontal disease. Radiographs act as valuable adjunct as they provide essential information regarding the morphology of residual bone and help in determining the prognosis, formulating treatment plan, and establishing the outcome of various therapies. Aims: The aim of the study was to compare the measurements obtained by conventional (intraoral periapical [IOPA] radiographs) and digital radiographs (radiovisiography [RVG]) for the assessment of alveolar bone by utilizing intrasurgical (IS) measurements as the gold standard. Methods: Thirty systemically healthy periodontitis patients with 100 interproximal sites were selected to undergo periodontal flap surgery. IOPA radiographs and RVG were taken before surgery using paralleling cone technique with the help of extension cone paralleling technique (XCP)®. Measurements in case of horizontal and vertical bone loss were taken and compared to IS measurements. Statistical Analysis Used: Analysis of variance and post hoc test were used. Results: No statistically significant difference was found between conventional and digital radiographic method in comparison to IS (IS) method for the assessment of alveolar bone level. Conclusion: Both radiographic methods (conventional and digital) showed statistically nonsignificant results in comparison to IS measurements. Hence, either IOPA radiograph or RVG can be used to visualize the alveolar bone level in periodontal disease.

Correlation of near-infrared spectral tomography (NIRST) with residual cancer burden (RCB) for prognostic assessment subsequent to neoadjuvant chemotherapy (NAC) in breast cancer.

e12655 Background: NIRST provides biophysical data including oxy- and deoxy-hemoglobin, water, lipid, and scatter components, useful in distinguishing cancer from normal breast tissue. Unlike anatomic changes characterized by conventional radiographic techniques, these functional changes are uniquely suited to monitor early response to NAC. The Residual Cancer Burden (RCB) is a reproducible pathologic analysis to evaluate residual disease after treatment with NAC and proven useful prognostically. Methods: 19 women with locally advanced breast cancer were enrolled in this NIRST pilot study to evaluate tumor response to NAC. Patients underwent NIRST prior to NAC (HbT-pre), after cycle 1, after cycle 2, at the mid-point of NAC, and at the conclusion of NAC. RCB scores were determined in 16 of the 19 final tissue specimens. RCB scores for two patients were excluded due to positive excisional lymph node biopsy prior to NAC. One patient underwent surgery at an outside hospital and was excluded as pathology slides were unavailable. The RCB class was compared to NIRST biophysical data at time points throughout NAC. Ratios relative to the pretreatment average of the normal contralateral breast were used for statistical analysis to minimize inter-subject variability of breast density and the effect on biophysical data. Results: The best predictor for RCB class was the early change in total hemoglobin (HbT-Δ) (percent change when comparing the first cycle of NAC to HbT-pre), as analyzed by Pearson correlation coefficient of 0.71. The significance of this correlation was evaluated using a two-sided t-test. The resulting P-value of 0.0019 demonstrates a statistically significant correlation. Conclusions: In this pilot study of NIRST, we demonstrate a statistically significant correlation between HbT-Δ change during the first cycle of NAC and the RCB. These findings suggest the potential utility of this approach, and warrant further evaluation in a larger study. The ability to determine response within the first cycle of NAC would be of great clinical utility, and additionally of potential use in clinical trials involving novel neoadjuvant therapies.

Comparison between conventional and digital radiography in assessing alveolar bone loss: An original research

Aim: The aim of this study was to compare the efficiency of conventional and digital radiography in assessing alveolar bone loss. Materials and Methods: The study group comprised 50 participants (25 males and 25 females) between 25 and 45 years of age. The participants were screened for all clinical features of periodontitis. A series of conventional bitewing radiographs of right and left of both maxillary and mandibular posterior region (15,16,17,25,26,27,35,36,37,45,46,47) were taken for each of 50 patients by examiner 1. Similarly, a series of digital bitewing radiographs were taken by examiner 2 for each 50 patients by using RVG of Planmeca Dixi 2 B Series. In digital bitewing radiographs, the measurement was done by examiner 2, using Planmeca Dixi 2 B Digital Software, by dragging the cursor to make a line by joining the linear points. Bone level less than 2 mm from the cementoenamel junction (CEJ) was considered normal while above that was considered bone loss. In case of conventional bitewing radiographs, alveolar bone loss was measured by the same examiner by measuring the distance from the CEJ to the most apical level of crestal bone using a divider and transparent ruler. The above collected data of examiners 1 and 2 were handed over to examiner 3 for statistical evaluation. Results: Comparison of conventional and digital radiographic techniques in left maxilla, left and right mandible, and between maxilla and mandible in the total sample and in females aged 25–35 and 36–45 years yielded a significant correlation while comparison of the two techniques in the right maxilla and between maxilla and mandible in males yielded a nonsignificant correlation. Conclusion: Direct digital radiography provides an edge over conventional radiography in assessing the periodontal bone destruction.