Digital Radiography Research Articles

Varus-valgus native knee laxity in extension displays an almost rectangular pattern and does not correlate with lower limb alignment.

Optimal ligament balance is crucial for successful total knee arthroplasty (TKA), which is a standard procedure for managing end-stage knee osteoarthritis. However, the reported values of ligament balance vary due to different methodologies and population differences, which requires further studies. This study aimed to investigate the varus-valgus ligament balance in healthy knees of Japanese individuals and its relationship with lower limb alignment. The studyanalyzed64 knees from 33 healthy young adults using stress radiographs to measure varus-valgus laxity. The mechanical hip-knee-ankle angle, medial proximal tibial angle, and lateral distal femoral angles were determined using digital long-leg radiographs. Varus and valgus laxities were compared, and the relationship between ligament balance and alignment parameters was analyzed. Mean varus laxity (3.6°± 1.3°) was significantly greater than mean valgus laxity(2.9°± 1.0°) (p<0.0001). No significant association was observed between ligament balance and alignment parameters. Healthy knees of Japanese individuals exhibited slightly greater varus laxity (0.7°) than valgus laxity, with no correlation observed between ligament balance and lower limb alignment. The finding underscores the importance of recognizing alignment diversity while noting that alignment does not influence ligament balance; this is particularly relevant in modern TKA techniques focusing on patient-specific joint and ligament reconstructions. The study's findings could help formulate strategies benefiting knee osteoarthritis management.

Novel MRI Signs in Atlantodental Space Predict Reduction Degree of Atlantoaxial Dislocation.

The type of atlantodental space tissue in patients with atlantoaxial dislocation (AAD) can help doctors understand the possibility of reduction before surgery. However, relevant research on this topic is lacking. This study aimed to summarize cases of AAD, classified based on the atlantodental space using magnetic resonance imaging (MRI), and preliminarily explore its impact on the degree of reduction. Preoperative T2-weighted MRIs and dynamic digital radiographs of patients who underwent posterior reduction and fixation surgery for congenital AAD between September 2012 and February 2023 were collected. The patients were classified into flexible and inflexible tissue sign groups based on T2-weighted imaging. Patients with an atlantodental interval < 3 mm on extension digital radiography were considered radiographically reducible. Three radiologists read and recorded the MRI results using standard protocols. Kappa and Fleiss kappa values were used to evaluate intra- and inter-observer agreements for MRI signs and dynamic digital radiography findings. Multivariate logistic regression and receiver operating characteristic curves were used to analyze the relationships between imaging parameters and the reduction degree. In total, 118 patients with AAD were included in the analysis. Inter-observer agreement among the three readers was higher for MRI than for dynamic digital radiography (0.816 vs. 0.668). The intra-observer consistency for MRI signs was also better than that of dynamic digital radiography. Both the flexible tissue sign and radiographically reducible groups showed a higher rate of satisfactory reduction. However, only the flexible tissue sign showed positive results in the multivariate regression. The receiver operating characteristic curve for MRI signs as a predictor of satisfactory reduction yielded an area under the curve of 0.776 (95% confidence interval, 0.667-0.875, p < 0.0001). Novel MRI signs of the atlantodental space exhibited high inter- and intra-observer agreement. Patients with flexible tissue signs were more likely to achieve satisfactory reduction after direct posterior surgery.

ESTIMATION OF DOSE ESTIMATION USING THE SPECIFIC DOSE SIZE METHOD OF RADIOGRAPH IMAGE REPEAT ANALYSIS AS A FORM OF RADIATION SAFETY IN THE RADIOLOGY INSTALLATION OF KLATEN ISLAMIC HOSPITAL

Repeat analyses are radiographs that are not clinically acceptable and are requested to be retaken. The primary purpose of the repeat analyses program is to take corrective action, record the repeated radiographic images, and determine the cause of the repetition so that it can be minimized or even eliminated. Klaten Islamic Hospital needs to keep its radiology services optimal and safe for patients as a referral hospital. One indicator of the quality of service is the low repetition rate of radiographic images. This study aims to determine the percentage of factors causing the repetition of radiographic images and suggested solutions to minimize repeat radiographic images in the Radiology Department. Survey research with a quantitative approach to repeating radiographic images at the Radiology Department. The study was conducted in February-May 2024 using observation, survey, and documentation. The percentage of repetition of radiographic images at the Radiology Installation of Klaten Islamic Hospital in the first month was 2.72%, in the second month was 3.04%, in the third month was 4.05%, and in the fourth month was 3.43%. Factors causing the repetition of radiographic images include miscollimation (clipped), artifacts, exposure factors, tools, and patient movement. Suggested solutions to minimize the factors causing the repetition of radiographic images in the Radiology Installation of Klaten Islamic Hospital are good communication between radiographers and patients, double checking before exposure, clear instructions to patients, ensuring there are no objects that can become artifacts, using appropriate exposure parameters, calibrating and testing suitability regularly, reporting if there is equipment damage, and using immobilization techniques. Keywords: Repeat Analyses, Digital Radiography, radiation safety for patient.

Navigating the digital frontier: transforming endodontic diagnosis through digitization. part 1

The current advances and innovations in material technology and armamentaria help to negate the difficulties faced by clinicians in diagnosing and treating patients. Oral healthcare contributes much to the wellbeing of a person. However, the oral cavity is a small and difficult area in which to work since it is filled with vascularized mobile tissues and various shaped teeth, and connected to sinuses, nerve canals, lungs and the gastrointestinal tract via the trachea and pharynx. Moreover, each tooth has a complex root canal system that must be explored if it is infected or inflamed. Root canal treatment can be compared to entering a blind tunnel and treating something unseen. Endodontics is a field in dentistry where a clinician must use their tactile sense and correlate it with clinical knowledge, as well as skill, to treat dental infections. Digital evolution has simplified diagnosis, treatment planning, documentation and communication with patients, rendering more predictable outcomes and providing evidence for the healing or non-healing of disease. The evolution of digital radiography has offered us the best technology available. The present review discusses various helpful digital tools that are currently available, and future technologies that may guide clinicians in better diagnosis. CPD/Clinical Relevance: Advances in diagnostic tools have improved accuracy in identifying and treating dental pathologies, thereby achieving more predictable outcomes and enhancing patient care.

Discussion on effect of observation circumstances for image in digital radiography

The discriminability of the IQI in the film radiography is affected by the observation circumstance and the luminance of film viewer. ISO17636-2 states that the images of digital radiograph shall be examined in a dimmed room. However, it does not describe requirements for the observation environment in digital radiography, despite the fact that the environment is similar to that of a normal professional PC and the display of the images can be easily adjusted. In this report, the influence of the observation environment in digital radiography was compared as the parameters the wire diameter and the WL value of a display adjustment value when the minimum wire diameter of the image quality indicator (IQI) was percepted, using images of welded steel at t25mm and t50mm. For welded steel of t25mm, differences due to SNRN values and differences due to the observation environment of light and dark room were compared. For t50mm, differences due to the presence or absence of the observation mask for the single wire of wire IQI which is places in front of the display, differences due to the resolution and brightness of the PC monitor, and differences when the WL was adjusted arbitrarily or fixed were compared. For the Digital Radiographic testing (RT-D), the basic spatial resolutions (SRb) were obtained by measuring the profile and applying of visual observation with the duplex wire type IQI. On the other hand, when observing the image of wire type IQI, the observation ways that one was obtain the perceptible image for all wires and another was to get the perceptible single wire image by using the observation mask for watching each wire were applied. Moreover, the influence of window width (WW) and window level (WL) adjustment on the discrimination of wire-type IQI was examined by quantifying it as WW/WL. As a result, it was confirmed that the discriminality in the dimmed room and the adjustment of WW and WL were effective. In addition, using the observation a mask showed that the perception of the adjacent wire image affected observer cognition in IQI discrimination during image observation. When using viewer software profiling, SRb measurements were not affected by the observation environment, but the visual observation was affected by the environment, and when observing images in the dimmed room with RT-D, it was found that adjusting WW and WL had a greater effect on discrimination for images with low SNRN and low contrast.

Response to "Preoperative parameters (signalment, digital radiography, urinalysis, urine microbiological culture) and novel algorithm improve prediction of canine urocystolith composition".

Response to "Preoperative parameters (signalment, digital radiography, urinalysis, urine microbiological culture) and novel algorithm improve prediction of canine urocystolith composition".

Evaluation of radiation dose and cancer risk for paediatric digital radiography in a Moroccan hospital

Pediatric radiography is the first line of most diagnostic examinations and an effective tool that provides important information about the patient's health status.This study aims to investigate the Entrance Surface Dose (ESD) and organ doses for pediatric patients undergoing imaging procedures of the abdomen, chest, pelvis, and nasopharynx using Optically Stimulated Luminescence Dosimeters OSLDs and an anthropomorphic phantom.An ATOM pediatric 5-year-old phantom was imaged using a Digital Radiography (DR) based on similar conditions of routine radiography (exposure parameters kVp, mAs, SID: Source Image receptor Distance). The OSLDs were inserted at the appropriate sites to measure localized doses in the sensitive organs.The results showed that the entrance surface doses for the pediatric patients were 0.17 ± 0.03 mGy, 0.10 ± 0.00 mGy, 0.46 ± 0.00 mGy, and 0.42 ± 0.02 mGy, respectively, for the abdomen (AP), chest (AP), pelvis (AP), and nasopharynx (LAT). The range of organ doses were 0.05-0.45 mGy, 0.01-0.44 mGy, 0.13-1.05 mGy, and 0.084 -0.99 mGy for the abdomen, chest, pelvis, and nasopharynx examination, respectively. Effective doses (ED) were 0.088 ± 0.021 mSv, 0.011 ±0.004 mSv, 0.058 ±0.007 mSv, and 0.044 ±0.024 mSv for the abdomen, chest, pelvis, and nasopharynx examination, respectively.The likelihood of cancer, as determined by the ICRP health risk model with a rate of 500 cases per 10,000 person-Sv (5% per sievert), estimated that a 0.015 case of health risk (0.3 person-Sv × 5% per sievert) may in the future be attributable to four X-ray pediatric procedures conducted in 2022.The ESD, ED, and organ dose values are deemed acceptable compared to those reported in the literature. Although the risk of incidence and mortality from cancer during life is minimal, it should not be ignored.

Establishment of a Digital Laminography facility at the Malaysian Nuclear Agency

Digital Laminography (DL) is a technique that enables the estimation of indication depth from a set of digital projection radiographs. It allows the engineers or researchers to visualize and measure the depth from the object’s surface. The technique applies to welded components and non-metal applications such as composite materials. The technique also allows users to understand engineering problems and further analyze the cause of failures. Malaysian Nuclear Agency is pursuing the building and establishment the DL system at its facility. A gantry is designed to hold a 225kVp X-ray tube that is mechanically moved slowly. A 100 µm pixel size Digital Detector Array (DDA) is used to capture the images. This paper highlights simulation and a preliminary assessment to understand the physics and appropriate steps to build a DL system. It discusses the simulation and experimental study of exposure parameters and setup by digital radiographic testing (RT-D) of known imperfections of a welded steel plate before performing the DL measurement. The radiographic images and their achieved contrast sensitivity and image quality are analyzed according to ISO 17636-2. The results of simulations and experiments demonstrate a good and consistent ability to measure the depth and extension of the reconstructed imperfections within ± 1 mm regarding the actual size and position.

Influence of clinical experience in detecting calcifications of the head and neck region on panoramic radiographs: an app-based evaluation.

Digital panoramic radiographs (DPRs) are used in dental practice as the first diagnostic tool for the initial detection of head and neck regions soft-tissue calcifications. The aim of this study was to use a self-developed application (App) to evaluate the ability of dental students at different levels of training to examine known DPRs with different soft-tissue calcification. A total of known 100 DPRs with (n=50) and without (n=50) calcification were independently evaluated by four groups: preclinical, first clinical and last clinical dental students, and dentists with less than or equal to 1 year of professional experience in the same time (15min) and examination conditions. Unity software was used to develop the examination App, which allowed to mark areas with calcifications on the DPRs. The data were statistically analyzed between the groups (significance level: P<0.05) for every location, and the detection rate was calculated as a percentage of detected calcifications. Results revealed that the overall detection rate of calcifications in all groups was 29.17%. Dentists exhibited the highest detection rate (36.46%), followed by the last- (29.69%), first- (32.29%), and preclinical (15.10%) students. These findings suggest that clinical experience plays a role in the correct detection of soft-tissue calcifications in DPRs. However, deficiencies in radiological training during dental education may contribute to diagnostic errors. As these can become life-threatening risks, the results highlight the need for early training in the dental curriculum to improve diagnostic performance and minimize possible diagnostic errors.

Radiological Evaluation of Marginal Bone Loss around Dental Implants with Two Different Collar Designs

Objective: To compare mean peri-implant Marginal Bone Loss in patients receiving dental implants with micro-threaded collars with those receiving dental implants with machined collars. Study Design: Quasi-experimental study. Place and Duration of Study: Prosthodontics Department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Marginal bone loss surrounding dental implants was evaluated by measuring peri-implant bone levels at the time of placement (T0), and at 3 months (T1) and 6 months (T2) after placement. Bone level around implant was measured from the top of dental implant to the first point of contact between the marginal bone and implant body with the help of digital peri apical radiograph (Care stream RVG 6500) with built in software measuring tool (Dental Imaging Software 6.14.0). Results: A total of 80 implants were placed in which 40 were with rough micro-threaded collar (Group-A) and 40 were with smooth machined collar (Group-B). Out of 80 patients, 51(63.75%) were males and 29(36.25%) were females. Mean and SD of age in years was 40.52±11.75 years. Highest bone loss was at T2 in machined collar implant i.e. 0.72±0.04 mm, and lowest bone loss at T2 in micro-threaded collar implant i.e. 0.54±0.04 mm. A statistically significant difference was found between MBL in machined and micro-threaded implants at T2 (p-0.001). Conclusion: Marginal bone loss around rough-surfaced micro-threaded collar implants was significantly lower than machined collar implants.

Evaluation of Crestal Bone Loss after Placement of Bone Graft around the Oral Implant with/without Platelet-rich Plasma.

The current investigation aimed to evaluate the crestal bone loss after placement of bone graft around the oral implant with/without platelet-rich plasma (PRP). Forty patients seeking for crown supported by dental implants to replace at least one lost tooth were included in the present study. The participants were divided into two groups at random (n = 20): Group I: Received tricalcium phosphate (TCP) along with PRP and group II: Received TCP without PRP. Digital radiographs were used to quantify the crestal bone levels on the mesial, distal, buccal, and lingual side of each implant after surgery, also at 3 months and 6 months follow-up period. Data were recorded and subjected to statistical analysis. After 3 months, the crestal bone level in TCP with PRP group, mesial side was 1.02 ± 0.18, distal was 1.14 ± 0.11, buccal was 1.18 ± 0.12 and lingual was 1.16 ± 0.16. In only TCP group, mesial side was 1.14 ± 0.02, distal was 1.24 ± 0.10, buccal was 1.38 ± 0.12 and lingual was 1.30 ± 0.08. There was a statistically significant difference between the two groups. After 6 months, the crestal bone level in TCP with PRP group, mesial side was 1.26 ± 0.02, distal was 1.38 ± 0.14, buccal was 1.44 ± 0.09, and lingual was 1.52 ± 0.12. In only TCP group, mesial side was 1.40 ± 0.10, distal was 1.56 ± 0.12, buccal was 1.62 ± 0.06, and lingual was 1.84 ± 0.04. There was a statistically significant difference between the two groups at 3 and 6 months. On conclusion, considerable crestal bone loss was observed in both treatment regimens. But TCP bone graft with PRP group found decreased bone loss around the dental implants than only TCP bone graft group. The most important aspects of controlling crestal bone loss are choosing the right implant design and bone transplant materials. Also, platelet-rich fibrin plays an important role in accelerating the healing process, improving bone regeneration, and repairing as it contains a high amount of growth factors and inflammatory chemicals. How to cite this article: Jalaluddin M, Awasthi A, Aljulayfi IS, et al. Evaluation of Crestal Bone Loss after Placement of Bone Graft around the Oral Implant with/without Platelet-rich Plasma. J Contemp Dent Pract 2024;25(7):645-648.

MONITORING OF A SEVERE COVID-19 PATIENT WITH PNEUMOTHORAX COMPLICATIONS THROUGH RADIOLOGICAL AND LABORATORY DIAGNOSIS

Introduction: Monitoring and treatment of severely ill patients with the coronavirus disease who are on mechanical ventilation due to the severity of the disease with the development of many complications remains a challenge. The increased incidence of pneumothorax in Covid-19 patients on mechanical ventilation may be due to a combination of infection-induced parenchymal injury and infl ammatory response with additional positive pressure ventilation. Materials and methods: In our study, we report a case of a severe Covid-19 patient with a pneumothorax complication through radiological and laboratory diagnostics. The performed radiogram of the lungs was taken each time in the AP projection in a semi-sitting position. A digital mobile X-ray device was used for imaging. All laboratory parameters that were monitored in the patient are performed in the panel of standard routine controls for patients with Covid-19. Results: The radiogram was better as the administration of therapy and chest drain were eff ective. Biochemical and hematological parameters are performed, which indicate a decrease in the number in blood count and biochemistry. The patient spent a total of 80 days in the hospital. Conclusion: Survival of a severe form of Covid-19 infection with the complication of pneumothorax is very rare, but still possible, as shown in our case. A chest radiograph with laboratory monitoring of the condition is of great importance in establishing the diagnosis of Covid-19 infection, and in the fi nal assessment of the patient's condition upon discharge from the hospital. Keywords: Covid-19, mechanical ventilation, pneumothorax, radiological diagnostics, laboratory diagnostics.

Tube voltage in chest and abdomen DR imaging: Which settings return maximal non-prewhitening model observer with eye filter (NPWE) detectability?

The non-prewhitening computational model observer with eye filter (NPWE) has been shown to reasonably predict human observer performance in general radiography and is an appropriate substitute when real clinical trials are not feasible. In this study, the NPWE model observer is used to detect specific tasks (circular designer nodules) ranging between 1 and 30mm in diameter using chest and abdomen phantom images acquired across the diagnostic energy range (60-125 kVp) with and without an anti-scatter grid. The aim of this study was to derive tube voltage (kVp) settings that return maximal NPWE detectability (d') of designer nodules, for digital radiography (DR) chest and abdomen imaging. Images of a chest phantom (LucAl phantom) and a surrogate for an abdomen (18.5cm PMMA) were acquired across the diagnostic energy range (60-125 kVp) with matched effective dose (for the respective anatomies), with and without an anti-scatter grid, on a general x-ray system. Images were captured using an Agfa DX-D 40C wireless indirect caesium iodide (CsI) imaging panel. Modulation transfer function (MTF), normalized noise power spectrum (NNPS), and contrast (C) were measured in each image and the detectability index d' was calculated for circular designer nodules with diameters ranging from 1 to 30mm (in steps of 1mm). The calculated d' peaked at a nodule diameter of 3mm irrespective of tube voltage, for both chest and abdomen images. A tube voltage of 80kVp returned maximal d' for chest imaging across all nodule diameters both with and without an anti-scatter grid. A tube voltage of 70 kVp returned maximal d' for abdomen imaging. The NPWE observer model has been used to derive tube voltages (kVp) that return maximal detectability (d') of designer nodules for chest and abdomen radiography using a modern DR imaging system. This will provide the medical physicist with a starting point in the task of optimising tube voltage range for chest and abdomen imaging.

Evaluation of clinical and radiographic warning signs for prediction of oroantral communication following tooth extractions

ObjectivesOroantral communication (OAC) is a relatively common and mild complication of maxillary tooth extractions. Preoperative prediction of OAC can reduce treatment duration and prepare both operators and patients for the procedure. This study aims to identify alarming radiographic and clinical indicators that can predict OAC therefore assisting clinical decision making to practicing general dentists.MethodsIn this retrospective case–control study the OAC group consisting of 97 cases and a control group twice the size was established. Clinical data were collected, and measurements were conducted separately by two blinded observers on digital panoramic radiographs. Inter-rater reliability was assessed. In case of disagreement a third observer’s results were utilized. The correlation between OAC and demographic data (age, sex), as well as various factors assessed on panoramic radiographs (including, but not limited to, the length of the root, root projection into the sinus, bone width, presence of mesial and distal adjacent teeth), was statistically evaluated.ResultsInter-rater reliability was found to be excellent. Several factors were identified as potential predictors of OAC. According to our model, the strongest predictors were the distance between the cemento-enamel junction and marginal bone, extent of root projection into the sinus, presence of sinus recess around the roots, angulation, and absence of the mesial adjacent tooth.ConclusionsWell-defined measurements on panoramic radiographs may aid in predicting OAC. Further prospective investigations are necessary to confirm these indicators and address factors related to clinical examination and operation.Clinical relevanceWe present several clinical and radiographic warning signs of OAC that can facilitate pre-extraction decision-making.

Impact of Aging and Knee Osteoarthritis on Lower Limb Alignment and CPAK Classification: Gender Differences in a Japanese Cohort.

Objective: This study investigates the impact of age and knee osteoarthritis (OA) on the coronal plane alignment of the lower extremity in Japanese males and females, utilizing the Coronal Plane Alignment of the Knee (CPAK) classification system. Methods: A cross-sectional analysis was conducted with 150 male and 150 female patients. Participants were divided into three groups according to age and OA progression. The mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were measured using standard digital long-leg radiographs. Arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO) were calculated, and the CPAK classification was performed to verify the distribution among the three groups. Results: The results showed increased varus alignment of the mean mLDFA correlated with OA in both genders and with aging in males. The mean mMPTA did not change in males but shifted toward varus in females with both aging and OA. Both genders demonstrated a constitutional varus alignment with the progression of osteoarthritis (males: 1.3 ± 2.4° to -3.5 ± 3.7°, p < 0.001; females: -1.2 ± 3.2° to -3.6 ± 2.9°, p < 0.001). However, this trend with aging was observed only in females (0.0 ± 2.5° to -1.2 ± 3.2°, p = 0.018). JLO maintained its apex distal position with aging and OA progression in all subjects. The study further revealed a notable transition from CPAK Type II to Type I with OA progression in both genders, additionally influenced by aging in females. Conclusions: Aging affects coronal alignment and CPAK classification differently across genders. With OA progression, there was a shift toward smaller aHKA, while JLO remained unchanged. Compared to other races, young Japanese people exhibit similar CPAK distributions, but distinct differences appear in OA-affected individuals, highlighting potential racial variations in CPAK classifications.

A novel frameshift deletion variant of ARSL associated with X-linked recessive chondrodysplasia punctata 1: a case report and literature review of prenatal, confirmed cases

BackgroundX-linked recessive chondrodysplasia punctata 1 (CDPX1) is a rare congenital skeletal dysplasia characterized by stippled epiphyses, nasal hypoplasia, and brachytelephalangy. ARSL (formerly known as ARSE), a member of the sulfatase gene family located on Xp22.3, has been identified as the causative gene for CDPX1. The high clinical and genetic heterogeneity of CDPX1 presents a challenge to prenatal diagnosis.Case presentationA G1P0 woman in her 30s with an unremarkable prenatal course presented in the second trimester. Maternal diseases, tobacco, alcohol, and drug history during pregnancy were denied. Obstetrical ultrasound examination revealed a flattened nose and a flattened midface with echogenic alterations of lumbar spinous process in the fetus. Amniocentesis was performed for genetic testing. A normal karyotype and a negative result of CNV-seq were obtained. However, Whole exome sequencing (WES) in trios revealed a hemizygous ARSL variant [NM_000047.3:c.1108del p.(Trp370Glyfs*35)] in the fetus, which was maternally inherited as confirmed by Sanger sequencing. This variant was absent from the genomAD and HGMD databases. According to the ACMG guidelines, this variant was interpreted as likely pathogenic (PVS1 + PM2_Supporting). The couple decided to terminate the pregnancy. After induction of labour, a severe nasal hypoplasia was noted; and brachytelephalangy was not remarkable. Postmortem digital X-ray imaging revealed symmetrical stippled epiphyses of the vertebrae in all spine regions and enlargement of spinous process of L1-L4 vertebrae.ConclusionA novel frameshift deletion variant of ARSL and the associated fetal phenotype have been identified. This study provides useful information for prenatal diagnosis and genetic counseling of CDPX1.

Biomechanical and Physical Characteristics of Dental Dam Sheets Used for Absolute Isolation.

This study aimed to evaluate the mechanical and physical properties of dental dam sheets used for absolute isolation and to correlate the mechanical parameters with cost. Twenty-one dental dam sheets were tested: ALLPRIME; Madeitex; Sanctuary non-latex, Sanctuary latex black, green, and blue; Nic Tone blue and black; Mk Life; Elastidam; Bassi; Pribanic; Care; OK; MDCDental; Keystone; Dura Dam; Flexidam; Sanctuary blue; Nic Tone blue; Ehros; and USE. The thicknesses of the dental dam sheets were measured using a digital micrometer (Mitutoyo). The dental dam sheets (n=15) were prepared by cutting the samples with dimensions of 80 × 10 mm with a 1.7 mm hole made at the center of each specimen, following the ISO 9001 standard. The specimens were tested using a universal testing machine (Emic) at a speed of 500 mm/min until rupture to calculate rupture force (RF, N), elongation (%), and ultimate tensile strength (UTS, MPa), their thickness (mm) was measured using a digital micrometer, and scanning electron microscopy and X-ray energy dispersive spectroscopy were performed to analyze the structure and composition. The radiopacity was measured using digital radiography. Thickness, UTS, RF, and elongation data were analyzed by one-way ANOVA and Tukey's test (α=0.05). The Flexidam dental dam had the largest thickness (0.5 mm), while Nic Tone had a median thickness of 0.3 mm; the RF value (41.3 N) was higher for the thicker dental dams. The other dental dams had RF values ranging from 19 to 30 N. The highest elongation was obtained for the non-latex Sanctuary dental dam (600 mm). The Bassi dental dam had the highest UTS value (15 MPa), and medium and small particles were observed in most of the gums. A loss of continuity was detected in the structure of Sanctuary green and blue media. The predominant elements in the sheets were carbon, magnesium, sulfur, silicon, and calcium. The UTS, RF, and elongation varied substantially, indicating insufficient standardization of dental dam sheets. Nonetheless, most of the tested dental dams exhibited mechanical and physical properties suitable for clinical use. The correlation between the cost and mechanical properties of the dental dams was very low.

Artificial intelligence in traumatology.

The aim of this study was to create artificial intelligence (AI) software with the purpose of providing a second opinion to physicians to support distal radius fracture (DRF) detection, and to compare the accuracy of fracture detection of physicians with and without software support. The dataset consisted of 26,121 anonymized anterior-posterior (AP) and lateral standard view radiographs of the wrist, with and without DRF. The convolutional neural network (CNN) model was trained to detect the presence of a DRF by comparing the radiographs containing a fracture to the inconspicuous ones. A total of 11 physicians (six surgeons in training and five hand surgeons) assessed 200 pairs of randomly selected digital radiographs of the wrist (AP and lateral) for the presence of a DRF. The same images were first evaluated without, and then with, the support of the CNN model, and the diagnostic accuracy of the two methods was compared. At the time of the study, the CNN model showed an area under the receiver operating curve of 0.97. AI assistance improved the physician's sensitivity (correct fracture detection) from 80% to 87%, and the specificity (correct fracture exclusion) from 91% to 95%. The overall error rate (combined false positive and false negative) was reduced from 14% without AI to 9% with AI. The use of a CNN model as a second opinion can improve the diagnostic accuracy of DRF detection in the study setting.

Deep learning for diagnostic charting on pediatric panoramic radiographs.

Artificial intelligence (AI)-based systems are used in dentistry to ensure a more accurate and efficient diagnostic process. The objective of the present study was to evaluate the performance of a deep learning (DL) program for the detection and classification of dental structures and treatments on panoramic radiographs of pediatric patients. In total, 4821 anonymized digital panoramic radiographs of children between 5 and 13 years of age were analyzed by YOLOv4, a CNN (Convolutional Neural Networks)-based object detection model. The ability to make a correct diagnosis was tested on samples from pediatric patients examined within the scope of the study. All statistical analyses were performed using SPSS version 26.0 software. The YOLOv4 model diagnosed the primary teeth, permanent tooth germs, and brackets successfully, with high F1 scores of 0.95, 0.90, and 0.76, respectively. Although this model achieved promising results, there were certain limitations for some dental structures and treatments, including fillings, root canal treatments, and supernumerary teeth. The architecture of the present study achieved reliable results, with some specific limitations for detecting dental structures and treatments. The detection of certain dental structures and previous dental treatments on pediatric panoramic radiographs by using a DL-based approach may provide early diagnosis of some dental anomalies and help dental practitioners to find more accurate treatment options by saving time and effort.

Radiation information, protection and awareness of healthcare professionals in terms of occupational health and safety: a two–center survey study

Abstract The objective of this study was to assess the level of knowledge, protection and awareness of radiation among healthcare professionals. A total of 413 healthcare professionals from two major training and research hospitals in Istanbul took part in the study. The sample consisted of 26.6% physicians and 73.4% other healthcare professionals. There was considerable variation in the knowledge of radiation content in imaging techniques, with correct response rates of 89.3% for Computed Tomography, 80.1% for digital x-ray, and 52.8% for Magnetic Resonance Imaging. While 69.5% of respondents provided correct answers to questions regarding radiation protection principles, 64.4% demonstrated a lack of sufficient knowledge in this area. It is noteworthy that 48.4% of respondents incorrectly identified the medical imaging technique to which the public is most exposed. It was concluded that further training on radiation-related issues should be provided at the university level and through in-service training for healthcare professionals.