Digital Radiography Research Articles

Gestion des déchets associés aux soins et éco responsabilité des cabinets dentaires en Tunisie : Enquête nationale

AIM or PURPOSE: The increasingly production of medical waste(MW) is a public health problem. The impact on human health and environment are very important. The aim of this study was to evaluate the practices and knowledges of Tunisian dentists about this field of interest.MATERIALS and METHOD: We conducted a cross sectional study. A self-administered questionnaire of 29 questions was published in a specific group of dentists in the social media. Data were collected immediately on GoogleForms and treated with SPSS.RESULTS: We collected 187 responses, of whom 82.8% were concerned about the impact of their practice on the environment. Practitioners who had been in practice for more than 10 years were more concerned about this issue (p=0.022).In 87,71% of cases, they stored the MW separetly, 12.3% outsourced to a waste management company. For the remaining, 95.12% of them disposed of in public bins. Most participants (87.3%) did not have a special container for sharps waste. Amalgam waste was disposed of with other waste for 35% of participants, increasing the risk of air and water contamination. The majority of participants used digital radiography (83.5%).Most participants (92.5%) had not received any training in healthcare waste management.CONCLUSION(S): There was a gap in the knowledge of proper MW management among Tunisian dentists. This issue must be a priority for the various national stakeholders involved, because protecting the environment is the responsibility of all of us. We must preserve this planet for future generations.

Prevalence of Decay and Tooth Condition Changes Adjacent to Restored Dental Implants: A Retrospective Radiographic Study.

This study examined the association between a dental implant and changes in adjacent teeth over time. Electronic health records of 1818 patients who received a dental implant were retrospectively evaluated over 14 years (2005-2019) in a university setting. The status of the adjacent tooth and vertical and horizontal distance from the implant platform to adjacent teeth were determined using digital intraoral radiographs taken at baseline and the last follow-up visit (1-14 years, median 4 years). In total, 1085 dental implants were evaluated. There were 234 instances of a change in the adjacent tooth. Decay was observed in 83 (7.6%) of adjacent teeth; the mean time to development was 4 years (range 1-14 years). Approximately 9% of adjacent teeth received direct restorations, 4.8% received indirect restorations, 1% received endodontic root canal treatment, and 5.6% were extracted. The mean horizontal distance between the implant platform and the adjacent teeth was 3.56 mm; the mean vertical distance from the contact point to the alveolar crest on the tooth side was 6.2 mm at the first time of the reported decay on X ray. These distances did not significantly influence the occurrence of caries. The prevalence of interproximal contact loss was higher on the mesial of the implant crown at 63% compared with 20% on the distal side. This large retrospective analysis identified that teeth adjacent to a dental implant were at risk of decay and changes in their condition. In addition, the implant-to-tooth distance and inadequate emergence profile may contribute as caries risk factors in addition to hygiene and a high sugar level diet. These findings appear essential for clinicians when making treatment decisions and discussing outcomes with patients.

Efficiency of the decision support system for determining the severity of scoliotic spinal deformity by the analysis of radiographs

BACKGROUND: In 2020, a decision support system was developed at expense of grant from Innovation Promotion Fund and integrated into medical base of prosthetic and orthopedic center “Sсoliologic.ru.” It is the first computer program for determining severity of scoliotic spinal deformity in analysis of radiographs. AIM: To evaluate performance of a computer program for determining Cobb angle by comparing obtained automated data with manual measurement data by various specialists. MATERIALS AND METHODS: From medical base of prosthetic and orthopedic center “Sсoliologic.ru,” 411 digital radiographs of spine of children and adolescents were selected, which were drawn by a radiologist (BP-etalon), an orthopedic traumatologist with 5 years of experience and experience in vertebrology (OO), and an orthopedic traumatologist with less than 1 year of experience and no experience in vertebrology (OB) and computer program (KP). The number and proportion of exact matches and mean absolute percentage error (MAPE) of results of measuring the Cobb angle of reference data were compared with indicators obtained by OO, OB, and KP in, for various types of scoliosis according to the classification of Rigо, as well as in determining the main arc. Bland–Altman graphs were used. The mean absolute deviation (MAD) and MAPE for the main arc with magnitude ranging from 20° to 50° were calculated. RESULTS: The exact matches of KP with standard were 21%. Hence, every fifth measurement of the Cobb angle on X-ray, calculated automatically, was identical to standard. The highest proportion of matches with standard was noted in OO (33%), and the lowest in OB (16%). The highest accuracy of KP was found at types E1 and E2, and the arc of 3 was 30% and 24%, respectively. The proportion of KP matches with standard increased to 61%, with an error of 3°, and to 75%, with an error of 5°; with an error of 7°, the proportion of matches reached 84%. Moreover, the proportion of coincidences of a non-experienced researcher increased from 34% to 58%. When determining magnitude of the main arc of scoliosis, OO increased his/her accuracy by almost 2,6 times, KP by 2,1 times, and OB by 1,5 times. The MAD of KP for all major arcs was 3.8°. Good reliability of the obtained KP indicators compared to the reference (ICC = 0.9) was noted. CONCLUSIONS: The use of a computer program may be recommended for automated determination of Cobb angle, because current algorithm of computer program has been found to be accurate compared to reference measurement. Its accuracy was significantly higher than that of novice orthopedic traumatologists with no experience in vertebrology.

Clinical, radiographic and biochemical assessment of proximal cavities restored with composite resin using incremental vs. bulk packing techniques: One-year randomized clinical trial

BackgroundBulk-fill resin composites may suffer from recurrent caries around compound proximal restorations in posterior teeth, especially at the proximo-gingival interface.Over 12 months, will the bulk fill technique affect the caries recurrence rate at gingival margins when compared to the conventional incremental packing technique? How early will the first clinical, radiographical, and biochemical evidence of caries recurrence occur?MethodsAfter randomization, in 30 patients with two compound (OM or OD) supragingival lesions, one tooth was restored using the bulk fill technique on one side (group 1) (n = 15). In contrast, the other tooth on the other side was restored utilizing the incremental layering technique (group 2) (n = 15). Both teeth received restorative material (X-tra fil, Voco, Cuxhaven, Germany). The FDI criteria were used to evaluate restorations. As for the periodontal assessment, the gingival index, plaque index, papillary bleeding scoring index and periodontal pocket depth were evaluated. The gingival crevicular fluid (GCF) specimens were gathered, and MMP-9 was extracted and quantitated by ELISA. A customized radiographic template was designed, and 3D printed digital bitewing radiographs were taken. Assessments were done clinically, radiographically and biochemically at baseline (1 week) and after 3, 6 and 12 months. Data was statistically analyzed.ResultsThe null hypothesis was accepted clinically; no statistically significant differences appeared between bulk and incrementally filled posterior restorations. As for the radiographic assessment, the null hypothesis was accepted except for increased periodontal ligament width at 3 months. The null hypothesis for the biochemical evaluation was rejected as there were significant changes in levels of MMP-9 at different testing times.Conclusions1. With similar results but less sensitivity and significant time saving, the bulk fill technique can be considered an efficient alternative to the incremental fill technique in restoring proximal cavities. 2. Early evidence of caries recurrence can be correlated to an increase in the MMP-9 level in gingival crevicular fluid, followed by an increase in radiographic periodontal ligament width measurement.Trial registrationAn ethical approval from the Research Ethics Committee at the Faculty of Dentistry, October 6 University, (Approval No. RECO6U/5-2022). The study was registered at the Pan African Clinical Trials Registry on 24/07/2023 with an identification number (PACTR202307573531455).

Prevalence and pattern of third molars impaction in a large Yemeni sample: a retrospective study.

The prevalence of teeth impaction varies substantially between different populations, and the impaction of third molars is the most commonly recorded. This study aimed to explore the prevalence and pattern of the third molars impactions among Yemeni population. This was a retrospective radiographic study conducted in Yemen between 2022 and 2023. The digital panoramic radiographs were collected from two major X-ray centers in Yemen. The angular position and depth of the impacted third molars were assessed according to the classifications of Winter and of Pell and Gregory, respectively. All radiographs were evaluated twice by one investigator in a two-week interval, and Kappa test was used for intra-rater reliability. Gender-wise differences, differences between both sides, and differences between maxilla and mandible were analyzed using Chi-squared tes with odds ratio (OR) for the risk of impaction. A P-value < 0.05 was considered significant. Panoramic radiographs of 6338 individuals were included. Their mean age was 35.1 ± 13.3 years andand 63.9% were females. A total of 25,352 sites (quadrants) were screened for the presence of thirds molars. Among which, 14,003 third molars (55.3%) were present in one or more sites. There were 1440 individuals (23%) with a total of 2828 impacted third molars (20% of the existing third molars). Females were less likely to have third molar impaction (OR = 0.46, CI95% = 0.4-0.52). Impaction of the mandibular third molars was significantly more frequent than the maxillary ones (OR = 1.15, CI95% = 1.04-1.26; P = 0.005). Horizontal and mesioangular impactions were statistically more frequent in the lower molars compared to the upper ones (P < 0.001 each). Contrastingly, vertical (P = 0.015), distoangular, and other impactions (P < 0.001 each)were statistically more frequent in the maxilla. Levels A and B were more frequent in the lower third molars, while level C was predominating in the upper molars (P < 0.001 each). The prevalence of third molars impaction is more frequent in males and mandibular arch. The angulation and level of impaction seem to be more complicated in the maxillary arch.

A virtual anti-scatter grid for multi-energy photon counting detector systems

Photon-counting (PC) systems are the next technological generation of medical computed tomography (CT) imaging and is being worked on by all major system providers. CT devices that are based on PC detectors enable multi-energy data collection. The information-content of this data can be used to obtain more detailed patient data, which improves the quality of reconstructions, compared to conventional detector systems. However, PC CT systems are subject to radiation scatter as just as any other imaging systems is. Conventionally anti-scatter grids (ASG) are used to reduce the scatter effect. These are however an imperfect solution, especially for PC detectors. In this work, a software-based scatter correction method, thus a virtual ASG is proposed. The method is tailoring a new statistical model in the measurement space and combining it with the statistical inversion method called Markov chain Monte Carlo (MCMC). The method can recover the measurement data from dense projections. We present the method on simulated data of a single photon emission computed tomography (SPECT) problem for which only under-sampled data is available. However, our approach can in principle be generalised to CT, PC-CT, Positron emission tomography (PET), radiotherapy, or even digital radiography problems. The results show that the proposed model performs similarly as physical ASGs and for cases where ASGs are not possible. The model further offers a significant improvement in the quality of the reconstruction image compared to the image reconstruction from original under-sampled data.

GREEN DENTISTRY: A SUSTAINABLE FUTURE FOR ORAL HEALTH CARE

The dental public health profession, like many others, is becoming increasingly aware of its environmental impact and the urgent need to adopt more sustainable practices. Green dentistry, also known as eco-friendly dentistry, is a growing movement that focuses on reducing waste, conserving energy, and minimizing pollution while maintaining high standards of patient care. By integrating environmentally conscious choices into daily practices—such as using digital technologies, reducing water consumption, and choosing biodegradable or recyclable materials—dentists can significantly contribute to environmental preservation without compromising the quality of their services. One of the core tenets of green dentistry is the shift towards digital dentistry. Traditional methods of record-keeping and patient management involve a considerable amount of paper and plastic waste. By adopting digital x-rays, patient records, and appointment scheduling systems, dental practices can dramatically reduce their paper use, lower radiation exposure, and decrease the need for disposable materials. Additionally, using energy-efficient equipment and eco-friendly sterilization techniques can help reduce the carbon footprint of dental offices, aligning with global sustainability goals. As the dental community moves towards greener practices, there is an opportunity for education and advocacy in dental public health. Dental schools and professional organizations play a crucial role in promoting awareness of sustainable practices among both practitioners and patients. By fostering a culture of environmental responsibility within the field, we not only contribute to a healthier planet but also inspire the next generation of dentists to prioritize sustainability in their professional lives. Green dentistry represents a vital step towards a more sustainable future for both the profession and the world at large.

Methods used for caries detection and diagnosis in Ontario dental practices: a cross-sectional survey

BackgroundEarly detection of caries is essential for applying non-surgical treatment procedures and preventing the formation of cavitated lesions leading to unnecessary removal of tooth structure. Understanding dentists’ preferences for caries detection tools can inform stakeholders about their strategies and knowledge of contemporary, evidence-based caries management approaches. However, there is a lack of research exploring the detection methods of caries commonly used by dentists in Ontario, Canada. The objective of this study was to investigate the methods of caries detection and diagnosis preferred by dentists in Ontario.MethodsA 21-item self-reported survey was mailed to one thousand Ontario dental practices in the Winter of 2022. Descriptive and bivariate data analysis were performed to determine the associations between: demographics and professional practice characteristics (explanatory variables), and methods for detecting and diagnosing dental caries (outcome variables) using SPSS Statistics 29.0.ResultsA total of 325 dentists (33%) responded to the survey, with 274 answering all of the questions completely. The highest proportion of respondents were 35–44 years of age (32.8%) and male (53.4%). More than half of the respondents reported using a dental explorer to assess primary occlusal caries (57.6%), secondary caries (57.1%), and cervical caries (57.5%). Likewise, 57.9% of the participants reported using dental radiographs to diagnose proximal caries. Among additional caries detection tools, digital radiography (89.8%) and traditional radiography (84.7%) were the most used methods/modalities, while cone beam computed tomography was the least (12.8%). Most study participants did not use any caries classification system (77.7%) or caries risk assessment tool (85.3%).ConclusionsParticipants preferred conventional methods for caries detection, instead of contemporary visual-tactile caries lesions classification and/or caries risk assessment systems. These findings indicate a need for continuing dental education programs tailored to evidence-based caries management approaches.

Panoramic evaluation of external root resorption in mandibular molars during orthodontic treatment: a comparison between root-filled and vital teeth treated with fixed appliances or clear aligners

BackgroundThis investigation compared the extent of external apical root resorption (EARR) in root-filled teeth (RFT) and their contralateral vital pulp teeth (VPT) counterparts during orthodontic treatment (OT) with clear aligner (CA) treatment or fixed appliance (FA) treatment.MethodsSixty-six patients with similar baseline American Board of Orthodontics (ABO) discrepancy index scores were divided into two groups: 37 patients (21 females, 16 males; mean age 17.45 ± 2.67 years) in the FA group, and 29 patients (18 females, 11 males; mean age 18.33 ± 1.96 years) in the CA group. Digital panoramic radiographs captured pre- and post-OT were used to measure tooth lengths and root surface measurements in mandibular molars. EARR in both RFT and contralateral VPT was evaluated pre- and post-OT. Statistical analysis employed paired t-tests, independent t-tests, and analysis of covariance (ANCOVA) (p < .05).ResultsAll teeth exhibited varying degrees of EARR following OT. FA treatment resulted in significantly longer treatment duration (p < .05) and greater EARR compared to CA treatment (p < .05). Moreover, statistically significant differences in EARR were observed within both groups between RFT and VPT (p < .05).ConclusionsComparison of pre- and post-OT radiographs revealed different degrees of EARR in all teeth. CA treatment resulted in less frequent and less severe EARR compared to FA treatment. RFT demonstrated greater resistance to EARR than VPT in both treatment groups.

Evaluation of the detector linearity response of the DR system in different x-ray bean filters

In the recent past, at Brazilian radiology services, direct digital radiography (DR) systems are replacing Computed Radiography (CR). This situation provides several significant advantages such as improving digital image quality, patient effective dose reduction, and improved speed of examinations performed. To evaluate DR systems, various organizations have published protocols with guidelines concerning quality assurance and acceptance tests for DRs. In these protocols, there are methodologies for evaluating several parameters, such as the detector linearity response (DLR). To test the DLR, different methodologies are proposed by the organizations, such as the application of different additional filters on the X-ray beams spectrum to promote the X-ray doses suitable to produce the latent image in the DR. The objective of this work was to evaluate the results of different protocol methodologies for carrying out the DLR test of a DR flat panel. An analogic radiology equipment, a primary ionization chamber, a DR system and images unprocessed were used in this study. As indicated by the protocols, the spectra of the X-rays were modified by additional filters of copper (Cu) with aluminum (Al); Al; Cu; and polymethylmethacrylate (PMMA). The spectra of the X-rays were modified to achieve the exposure range of 0.1 to 7 mR. The results showed that the DLR curves adjustment were R²&gt;0.99, for a logarithmic equation, type y=a.ln(x)+b. For the filters of 0.5 mmCu with 1.0 mmAl; 11.5 mmAl; 1.0 mmCu; 21 mmAl the mean pixel values showed 0.9% of the coefficient of variation (COV), while for 10 cm PMMA filters, the COV increased to 2.7%. The study showed that methodologies using Al, Cu and Al with Cu filters DLR have similar responses while using PMMA, the response was slightly different.

The L1 spino-pelvic (L1SP) angle: a simplified approach for the assessment of the PI-LL mismatch in hip surgery

Introduction: Pelvic incidence - lumbar lordosis (PI-LL) mismatch is often considered when assessing spinopelvic alignment in the sagittal plane. The mismatch is conventionally obtained by measuring 2 separate angles on lateral spinopelvic radiographs. This study describes a simplified approach for assessing spinopelvic mobility and measuring the PI-LL mismatch through the evaluation of the L1-spinopelvis angle (L1SP). Methods: 96 standing lateral radiographs were obtained from consecutive patients presenting for total hip arthroplasty between November 2020 and July 2021. 3 operators were recruited to annotate landmarks on digital radiographs. Correlation analysis and error analysis were applied. Measurement reproducibility was assessed using intraclass correlation coefficient (ICC). Results: The correlation coefficients of the 3 variables were respectively 0.87 for PI, 0.94 for LL, and 0.96 for L1SP. The normalised root mean square error between the 2 measurement sets was 9.96% for PI, 5.97% for LL, and 4.41% for L1SP. The absolute error was 3.49° ± 4.63° for PI, 3.23° ± 3.78° for LL, 2.68° ± 3.19° for PI-LL conventional, and 2.35° ± 2.88° for PI-LL via L1SP, respectively. In terms of reproducibility, measurement of L1SP outperformed that of PI and LL (ICC = 0.97 versus 0.83 and 0.93, respectively). Conclusion: The simplified L1SP method, through the measurement of a single angle, produced similar measurements to the conventional PI-LL method. The measurement repeatability between operators was improved using the L1SP method. From a clinical practice perspective, both methods are equivalent. The new method is readily reproducible using commercially available PACS software during preoperative templating.

Evaluation of Radiopacity of Calcium Silicate-Based and Resin-Based Materials Using Direct Digital Radiography Along With an Aluminium Step Wedge.

Background Radiopacity is a critical property for root canal sealers as it allows for the assessment of the material's placement and quality within the root canal system on radiographic images. The study aimed to evaluate the radiopacity of calcium silicate-based and resin-based materials using direct digital radiography, employing an aluminium step wedge according toAmerican National Standards Institute/International Organization for Standardization (ANSI/ISO) standard protocols for testing the radiopacity of root canal sealers. This study seeks to determine the effectiveness of these materials in meeting the required standards for clinical use. Methodology The materials tested were AH Plus, Apexit Plus, Biodentine and MTA Fillapex in circular disc form and radiographed alongsidethe aluminium step wedge using direct digital radiography to determine the radiopacity using grey-pixel values. All the materials, viz., AH Plus, Apexit Plus, Biodentine and MTA Fillapex were found satisfactorily radiopaque and met the minimum radiopacity standard, that is, minimum 3mm of aluminium recommended by ANSI/American Dental Association (ADA) Specification No. 57. Results AH Plus exhibited the highest radiopacity with values of 222.54 mm Al Eq (isodensity) and 220.88 mm Al Eq (densitometric), significantly surpassing Apexit Plus, Fillapexand Biodentine (p < 0.001). Apexit Plus and Fillapex showed no significant difference between them (p = 0.238), but both were significantly higher than Biodentine (p < 0.001). Biodentine had the lowest radiopacity among all the sealers tested. Conclusion All the tested materials met the ANSI/ADA minimum radiopacity standard, demonstrating their suitability for clinical use. The materials varied in their levels of radiopacity, demonstrating that they are adequately visible on radiographic images for effective assessment in root canal treatments.

Anatomy, digital radiography and cone-beam computed tomography of Western European hedgehog (Erinaceus europaeus) skull

BackgroundEuropean hedgehogs (Erinaceus europaeus) are small insectivorous mammals common in Europe. With increased urbanization, the species become more frequent in the cities and near other human dwellings. The anatomy of the species with the use of diagnostic imaging techniques along with the classical anatomical methodology has not been researched before. In addition to the description of this species' skull, the data may contribute to progress in hedgehog medicine, delivering a basis for diagnosing and treating head trauma in this species.ResultsCadavers of 30 European hedgehogs have been used to study the anatomy of the head of the species. Along with classical anatomical techniques – latex and corrosion cast specimens, x-ray, and cone-bean computed tomography scans were performed. The methods were then compared, and the detailed anatomy of the head was described. The skull of the Western European hedgehog was elongated and oval in shape, and could be divided into two distinct regions: one formed of neurocranial bones and the other of facial bones. The neurocranium was composed of the following bones: the occipital, interparietal, parietal, frontal, temporal, sphenoid, ethmoid, and pterygoid bones. The following facial bones were identified: the incisive, nasal, maxilla, zygomatic, palatine, vomer, and the mandible. The most important findings include the primitive tympanic bullae, the absence of a supraorbital foramen, and the lacrimal bones, which were indistinguishably fused with the maxillae.ConclusionsThe results of the study may be used in future research on the comparative anatomy of the other members of the Eulipotyphla order. With the increase of hedgehogs in the cities, it is important to establish new diagnostic and treatment protocols for wildlife rehabilitation centers. Anatomical and radiological descriptions may be used as a base for such work. The anatomical features of the hedgehog skull described in the study may prove useful for further studies from a comparative anatomical perspective. Additionally, the data may serve as a basis for developing identification guidelines for archaeological studies and forensic research.

A new artificial intelligence program for the automatic evaluation of scoliosis on frontal spinal radiographs: Accuracy, advantages and limitations

BACKGROUND: Scoliosis is one of the most common spinal deformations that are usually diagnosed on frontal radiographs using Cobb’s method. Automatic measurement methods based on artificial intelligence can overcome many drawbacks of the usual method and can significantly save radiologist’s time. AIM: To analyze the accuracy, advantages, and disadvantages of a newly developed artificial intelligence program for the automatic diagnosis of scoliosis and measurement of Cobb’s angle on frontal radiographs. MATERIALS AND METHODS: In total, 114 digital radiographs were used to test the agreement of Cobb’s angle measurements between the new automatic method and the radiologist using the Bland–Altman method on Microsoft Excel. A limited clinical accuracy test was also conducted using 120 radiographs. The accuracy of the system in defining the scoliosis grade was evaluated by sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve. RESULTS: The agreement of Cobb’s angle measurement between the system and the radiologist’s calculation was found mostly in grade 1 and 2 scoliosis. Only 2.8% of the results showed a clinically significant angle variability of 5°. The diagnostic accuracy metrics of the limited clinical trial in City Mariinsky Hospital (Saint Petersburg, Russia) also proved the reliability of the system, with a sensitivity of 0.97, specificity of 0.88, accuracy (general validity) of 0.93, and area under the receiver operating characteristic curve of 0.93. CONCLUSION: Overall, the artificial intelligence program can automatically and accurately define the scoliosis grade and measure the angles of spinal curvatures on frontal radiographs.

A new superfamily of freshwater mussels Deccanoidea nov. (Mollusca: Unionida) from an intertrappean deposit of Saurashtra province (Gujarat state, western India): An example of disjunct distribution

The Cretaceous-Palaeogene intertrappean deposits of the Deccan Volcanic Province of India comprise vertebrate, invertebrate and plant fossils of the dominantly continental realm. A 3–4 m thick shaly-sandstone lacustrine intertrappean sequence of Early Palaeogene (Palaeocene-Early Eocene) Bamanbor Formation, Chotila Basin (Saurashtra province, Gujarat State, western India) has yielded a collection of molluscans (bivalve and few gastropods) fauna. High-resolution digital photography and radiography of the recovered bivalves allowed us to gain detailed inferences on shell morphology. In a taxonomical context, we herein propose a new unionid molluscan superfamily Deccanoidea nov. represented by a single new family Deccanoidae nov. that includes two new subfamilies, that is, Deccanoinae nov. (represented by two new genera Deccanoida gen. nov. [including four new species: D. conrugis sp. nov., D. aleta sp. nov., and D. costaria sp. nov.] and Bamanboria gen. nov. [including one new species Bamanboria oblongis gen. et sp. nov.] and Chotiloinae nov. [represented by one new genus Chotilia gen. nov. and three new species: Chotilia trappeansis sp. nov., C. tuberculata sp. nov. and C. deccanensis sp. nov.]). Inorganic geochemistry of host (unionid-yielding) lithologies reveals oxic-freshwater conditions, humid-climate and moderate rainfall. The data on historical biogeography reveals that the Indian subcontinent hosted unionids during the late Cretaceous; however, the presence of new (at family/generic level) unionid fauna during the Early Palaeogene (Palaeocene-Early Eocene) in India indicates changes in the geographic position and ecologic condition linked to northward drift and lava outpouring, respectively. A disjunct distribution of unionid fauna in the erstwhile Gondwanan continents and insular India during the Cretaceous-Palaeogene interval can be explained in terms of both vicariance and dispersal.

Педиатрическая рентгенография: проблемы и решения

Background: Because of children's distinct physiological and anatomical features, pediatric radiography necessitates particular techniques. Recent advances in medical physics have considerably improved the accuracy and safety of pediatric radiological procedures. However, these developments bring new obstacles. Objective: This article evaluates the most recent advances in medical physics relevant to pediatric radiography, highlights the accompanying problems, and provides feasible solutions to improve clinical results and patient safety. Methods: A thorough literature analysis focused on current research and technology advancements in pediatric radiology. The main advances in imaging technology, radiation dose control, and diagnostic accuracy were examined. Expert comments and case studies were also analyzed for common issues and solutions. Results: Low-dose imaging methods, such as digital radiography, pediatric-specific computed tomography (CT), and magnetic resonance imaging (MRI), have advanced significantly. These enhancements have resulted in better image quality and lower radiation exposure. However, patient size heterogeneity, motion artifacts, and the necessity for age-specific procedures remain common. Conclusion: Medical physics advancements have significantly enhanced pediatric radiology, allowing for higher diagnostic capabilities while reducing hazards. To address the remaining difficulties, radiologists must continue research, adopt standardized methods, and get continual education. Future advances should focus on lowering radiation exposure and enhancing imaging technologies' flexibility to meet pediatric patients' demands.

Is digital mammography reducing radiation doses to women?

This study aims to investigate the impact of national quality programs in mammography and technological advances in digital mammography units on the radiation doses delivered to women in Brazil. Radiation dose assessments in mammography units were conducted through a mail-based dosimetric system. For each unit of facilities that applied to one of the two national quality programs, a postal dosimetric system is dispatched, comprising an optically stimulated luminescent dosimeter (OSL) attached to the surface of a 4.0 cm thick polymethyl methacrylate (PMMA) phantom, simulating a compressed breast with 4.5 cm thickness. Testing instructions to expose the dosimetric phantom for assessing the mean glandular dose (MGD) are provided. Between 2012 and 2023, the programs evaluated the MGD in 1,687 mammography units of computed radiography (CR) and direct digital radiography (DR) technologies from 1,399 facilities located in all Brazilian regions. A total of 1,660 (70.5%) evaluations were carried out on CR technology mammography units and 696 (29.5%) on DR units, totaling 2,356 MGD evaluations. The overall average MGD was 1.60 ± 0.80 mGy, with 1.68 ± 0.83 mGy for CR technology and 1.42 ± 0.68 mGy for DR technology. A comparison of average MGD between the periods 2012 - 2018 and from 2019 onwards shows a dose reduction of 8.6% for CR systems and of 26.0% for DR systems (p = 0.000). As CR systems use analog mammography units, which did not undergo technological advances between the two periods, the reduction in doses observed is due to the actions of national quality certification programs and by using image plates for dual-sided reading or needle-based image plates. The reduction observed in DR systems is due to both national quality programs and technological advances in mammography units, especially the use of radiation beams generated by X-ray tubes with tungsten targets.

Description of bone health in adolescents and young persons with Klinefelter syndrome – results from a pilot study

BackgroundIn adults with Klinefelter syndrome (KS), impaired bone health with reduced bone mineral density (BMD) has been described even in the presence of testosterone replacement therapy. The aim of the present study was to characterize bone health in young patients with KS.Patients and methods20 participants aged 16.10 ± 4.28 years with KS (7 with testosterone replacement therapy) were included in the KliBONE study (DRKS 00024870). Medical history, clinical, radiographic and biochemical parameters of bone health and metabolism were obtained. Radiographic bone health index (BHI) was assessed via automated digital X-ray radiogrammetry of the left hand or via dual energy X-ray absorptiometry (DXA) of the lumbar spine and left femur in participants ≥ 16 years. Peripheral blood mononuclear cells were differentiated into osteoclasts and quantified in 7 participants and 7 healthy controls.ResultsMean BHI SDS was − 1.42 ± 1.22 and mean BMD z-score at the lumbar vertebrae (L1-4) was − 0.92 ± 1.00. 25-OH-vitamin D levels < 20 ng/ml were detected in 8/20. Other parameters of bone metabolism (bone-specific alkaline phosphatase, PTH, ß-crosslaps and osteocalcin) were within age-appropriate reference ranges. Serum leptin SDS was elevated (mean 2.15 ± 1.19). The number of osteoclasts in participants with KS did not differ from that of controls.ConclusionBHI SDS and BMD z-scores were lower than expected in young individuals with KS despite age-appropriate bone turnover markers and no apparent pathology in osteoclast differentiation. The cause of the early-onset bone phenotype requires further investigation.

Investigating the Frequency of Digital Technology Usage Among Dentists in Zahedan - 2023

Background: Many new technologies are being used in dentistry, enhancing and accelerating dental procedures. However, there is still a lack of a comprehensive and coherent understanding of the extent of technology use and the factors influencing its adoption in any specific society. Objectives: This study aimed to investigate the frequency of digital technology use among dentists in Zahedan, Iran, in 2023. Methods: In this descriptive-analytical study, ninety-three dentists working in Zahedan city were investigated. Simple random sampling was used to select participants, and a questionnaire was administered that included sections on demographic information (gender, experience, workplace, level of degree, level of education), administrative and communicative aspects (4 questions), clinical and diagnostic aspects (9 questions), and reasons for not using certain technologies. The validity of the questionnaire was 100%, and the reliability was 0.8. Data analysis was performed using frequency analysis and comparisons between groups, which were conducted using the chi-square or Fisher's exact test. A P-value of less than 0.05 (P &lt; 0.05) was considered statistically significant. Results: The usage rate of digital technologies among dentists in Zahedan was 60.2% low, 35.5% moderate, and 4.3% high. There was a significant relationship between the use of digital technologies and factors such as gender (P &lt; 0.001), workplace (P &lt; 0.001), experience (P &lt; 0.006), and level of education (P &lt; 0.002). However, no significant relationship was found between digital technology use and the level of degree. Digital radiography was the most commonly used technology, with a usage rate of 74.3%. The most frequently used administrative and communicative technology was the "use of communication program or software with other centers," at 49.9%. The majority of digital technologies began to be adopted from 2019 onwards. The main reason for not using administrative and communicative technologies was "inaccessibility," while the primary reason for not using clinical and diagnostic technologies was deemed "unnecessary use." Conclusions: The use of digital technologies by dentists in Zahedan was found to be low. Given the limited adoption of digital technologies in dentistry, it is essential to provide more training for dentists and to facilitate better access to these technologies in the field.

A Comparison of Two Methods of Dental Age Estimation in a Population of Saudi Children and Adolescents.

This study aimed to compare and evaluate the accuracy of the Demirjian (DE) and the London Atlas (LAE) dental age estimation methods in a Saudi population sample. This retrospective cross-sectional study used digital radiographs from electronic health records in three different dental institutes. In total, 357 male and 354 female (ages 5-15 years) digital orthopantomograms were selected for age estimation. The mean difference between the chronological age (CA) and age estimation method among males and females was 0.03 ± 0.34 and 0.00 ± 0.34, respectively, for LAE and 0.55 ± 0.84 and 0.76 ± 0.51, respectively, for DE. The mean difference between the LAE and DE methods among males and females was 0.52 ± 0.89 and -0.76 ± 0.57, respectively. No statistically significant difference between CA and LAE was found in either males (p = 0.079) or females (p = 0.872). A statistically significant difference was found between CA and DE in both genders (p < 0.001). A statistically significant difference was found between the LAE and DE groups (p < 0.001) in both genders. An overestimation of dental age was observed with DE compared with that in CA. LAE showed higher accuracy than CA, with no clinically significant difference. Although the difference between the LAE and DE methods was insignificant, the LAE method proved to be more accurate.