Digital Radiography Research Articles

Radiation shielding transmission data for modern digital radiography.

Radiography is one of the most widely used x-ray imaging modalities. In National Council on Radiation Protection and Measurements (NCRP) Report No. 147, transmission data for radiographic systems were evaluated on those installed before 2000. For x-ray systems (except intraoral dental) manufactured on or after June 10, 2006, the U.S. required minimum half-value layer (HVL) was increased; for example, 2.9 (2.3) mm Al at 80kV, where the value in parenthesis denotes the earlier requirement before the above date. To calculate the transmission of the broad x-ray beam of modern digital radiography (DR) through shielding materials. X-ray beam HVLs on two DR systems (Agfa DR 600, GE Revolution XR/d) were measured in 10kV increments between 60 and 120kV, with a calibrated ionization chamber (Radcal model 10×5-60) and varying thickness of aluminum 1100 plates. Monte Carlo (Geant4) simulation was performed to calculate the transmission of broad x-ray beams through lead, concrete, gypsum, and steel, with x-ray HVLs matching those of the DR 600 at two beam filtrations (default, 1mm Al plus 0.1mm Cu added filtration). The transmission data were fitted to the Archer equation. HVLs on two DR systems with default beam filtration were consistent (median difference, 2.1%; maximum difference, 5.5%). An additional beam filtration option (1mm Al plus 0.1mm Cu) on the DR 600 substantially increased HVLs by 45.2%-61.2%. Transmission fitting parameters were provided for seven tube voltages (60-120kV) at two beam filtrations. This work presents transmission data for modern DR systems, indicating increased x-ray beam filtration compared to the primary x-ray beam in NCRP Report No. 147. The updated transmission data can enhance structural shielding evaluations at individual tube voltages or with a workload distribution.

Evaluation of fractal analysis and radiomorphometric measurements of mandibular bone structure in bruxism and non-bruxism paediatric patients.

The goal of this examination was to compare the impact of probable sleep/awake bruxism on the mandibular trabecular bone structure by fractal analysis (FA) with digital panoramic radiograph (DPR) and radiomorphometric measurements in paediatric patients with bruxism. The examination included 130 participants with 63 patients with probable sleep/awake bruxism and 67 control groups. Bilateral regions of interest (ROI) in three regions were examined as ROI1: mandibular ramus, ROI2: mandibular angulus, ROI3: anterior to the molar teeth. Radiomorphometric measurements were taken of the mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). p < 0.05 was approved for statistical significance. The ROI-1, ROI-2, and ROI-3 values were defined to be statistically significantly high in the bruxism group (p < 0.05). No significant difference was found between the groups in the other values (p > 0.05). There was no difference in the age and gender for any of the parameters (p > 0.05). In children and adolescents, the mandibular trabecular bone can be affected by bruxism. FA can be used as an auxiliary method for finding the mandibular trabecular differences of patients with bruxism in paediatric dentistry just as it can for adults.

Impacted third molar surgery in older patients—Is patient´s age really a risk factor for complications?

ObjectivesThe aim of this study was to analyze the influence of patients´ age on perioperative complications in impacted third molar surgery and how established risk factors are affected by age.Materials and methodsThe clinical findings, digital panoramic radiographs and perioperative data of 200 patients (554 impacted third molars) that had been subjected to tooth extraction, from July 2023 until July 2024, were analyzed. Perioperative complications (Inferior alveolar nerve (IAN) hypesthesia, oroantral communication (OAC), lingual nerve (LN) hypesthesia, postoperative bleeding, postoperative infection) as well as impaction patterns and risk factors (angulation type, bone coverage, depth- and risk scores) were analyzed by age (cut-off 30 years).ResultsThe population was divided into two groups by age (Group A = ≥ 30 years (n = 52) vs. Group B = < 30 years (n = 148)). Upper third molars showed significantly deeper bone coverage, higher depth scores, higher risk scores and different angulation types in patients aged < 30 years. Mandibular third molars showed significantly deeper bone coverage, higher depth scores, higher risk scores according and different angulation types in patients aged ≥ 30 years. However, IAN hypesthesia, LN hypesthesia, postoperative bleeding and postoperative infection did not show any significant differences regarding patients’ age.ConclusionThe current findings suggest that age (cut-off 30 years) does not statistically correlate with a higher risk for postoperative complications in impacted third molar surgery in contrast to recent publications.Clinical relevanceIn contrast to recent publications, the present study falsified a positive correlation between patients’ age and the occurrence of postoperative complications in impacted third molar surgery. Therefore, other risk factors should be investigated in order to minimize these procedure specific complications.

Does the Timing of Orthognathic Surgery Affect the Level of External Root Resorption?: Surgery-First Approach Versus Conventional Orthognathic Surgery.

This study aimed to compare external root resorption levels, both linearly and areally, on panoramic radiographs in Class III patients whose treatment was completed with the conventional orthognathic surgery and the surgery-first approach. The study included 20 patients (10 female, 10 male; 23.98±2.63y) treated with conventional orthognathic surgery and 18 patients (8 female, 10 male; 27.5±3.42y) treated with surgery-first approach was included. Linear and area measurements were made on the digital panoramic radiographs taken before and at the end of the treatment of 38 patients who constituted the sample of the study. The mean changes observed in each group were evaluated using a paired t test. The chronological ages, skeletal features (type of Class III malocclusion), treatment durations, initial values, and mean changes that occurred in each group were compared using independent t test. When the changes in root lengths and root surface areas were evaluated in all teeth in both groups, a significant loss in size was measured (P<0.001). More resorption was observed in teeth 12 and 22 in the conventional surgery group (P<0.05). When the amount of resorption in both groups was compared, there was significantly more resorption in tooth number 12 in the conventional surgery group (P<0.05). The study showed that there was external root resorption in all teeth in both protocols, but the root lengths of the lateral teeth were shortened more in both groups.

Diagnostic reference levels for the city of Moscow during X-ray examinations

Diagnostic reference levels are one of the effective tools for optimizing patient radiation doses in diagnostic radiology. The staff of domestic radiology departments does not have an understanding of the development process and use of diagnostic reference levels during X-ray examinations, although this tool is a generally accepted in practice abroad. The article shows the experience of forming regional diagnostic reference levels based on measurements provided by the accredited testing laboratory of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department. The diagnostic reference levels for radiography in Moscow were developed for eight of the most common types of examinations based on the operation of 216 digital X-ray machines. The resulting levels, expressed in the dose-area product (cGy-cm2) and effective dose (mSv), were compared with the local diagnostic reference levels for the Ryazan region, Russia, and national diagnostic reference levels for other countries. The analysis showed continuity in the values. Some types of studies have been optimized. The developed diagnostic reference levels are the quality performance indicators foe diagnostic radiology departments and will be used to optimize a patient radiation dose during diagnostic studies in Moscow.

Automated Defect Detection through Flaw Grading in Non-Destructive Testing Digital X-ray Radiography

Automated Defect Detection through Flaw Grading in Non-Destructive Testing Digital X-ray Radiography

Clinical and pathological characteristics of gastric large cell neuroendocrine carcinoma: A report of 2 cases series and literature review.

Gastric large cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive neuroendocrine carcinoma that arises from the stomach and with high malignancy. Patients with gastric LCNEC usually have a poor prognosis. The standard treatment plan has not been established and its curative effect is poor. The present study described 2 cases diagnosed with gastric LCNEC and reviewed in depth the literature to improve our understanding more about this uncommon tumor and further to provide more experience to diagnose and treat this disease. The present study reported 2 cases of gastric LCNEC in male patients aged 51 and 73 years old, respectively. Both patients had epigastric discomfort, pain, acid reflux and heartburn. The medical history was unremarkable. The ulcerative lesion located at gastric was examined in the 2 patients by taking the esophagogastroduodenoscopy (EGO), computed tomography (CT) and digital gastrointestinal radiography (GI), that both were suspected gastric malignancy. Endoscopic biopsies of the tumor led to the initial diagnosis of gastric cancer. Postoperative pathological and immunohistochemical examinations of the surgical specimens confirmed that 1 case had mixed adeno-neuroendocrine carcinoma (MANEC) and the other had LCNEC. Both patients underwent surgical resection and received etoposide-cisplatin combination chemotherapy following surgery. The operation was successful. Both patients had uneventful recoveries following surgery, and had been followed-up regularly. The general condition was satisfactory, and no tumor metastasis was observed at present.

Mandibular morphology in schizophrenia patients compared with non-psychiatric controls using digital panoramic radiography: a retrospective cross-sectional study from Istanbul, Türkiye

BackgroundSchizophrenia is a chronic severe mental disorder characterized by impairment in cognition, emotion, perception, and other aspects of behavior. In light of the association of craniofacial dysmorphology with schizophrenia, mandibular morphology may provide clues about the role of neurodevelopment in the pathophysiology of schizophrenia. This retrospective cross-sectional study aimed to compare the mandibular morphology of patients with schizophrenia with controls using digital panoramic radiography (DPR).Methods302 recorded diagnostic panoramic images obtained from 143 schizophrenia patients (98 males, 45 females), and 159 controls (73 males, 86 females), aged 18–45 years, were evaluated. Seven mandibular measurements consisting of ramus height, condylar height, gonial angle, antegonial angle, antegonial notch depth, ramal notch depth and bigonial width were measured from the DPRs in a double-blinded manner. Bivariate comparisons were carried out using the Independent t-test and Mann–Whitney U test. Logistic regression analysis was used for multivariate comparisons.ResultsLinear measurements were higher while angular measurements were lower in schizophrenia patients. Regression analyses indicated that female patients had greater ramus height (OR = 1.243; P = 0.001), condylar height (OR = 1.463; P = 0.048) and bigonial width (OR = 1.082; P < 0.001); male patients had greater ramus heights (OR = 1.216; P = 0.001) and bigonial width (OR = 1.076; P < 0.001) as well as lower antegonial angle (OR = 0.908; P = 0.012) compared to their respective controls.ConclusionQuantitative differences in mandibular morphology in schizophrenia patients versus controls deserve attention and corroborate with the concept of abnormal neurodevelopment in schizophrenia.

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.

Comparative Evaluation of Condylar Guidance Obtained by Digital Panoramic Radiographic Images Using Two Different Interocclusal Recording Material During Jaw Relation in Completely Edentulous Patients: An In Vivo Study.

Objective To compare the condylar guidance value obtained during jaw relation by two different interocclusal recording materials to that obtained from OPG (Orthopantomogram). Materials and methods Two different interocclusal recording materials were used, namely bite registration wax (reinforced wax, by MAARC Dental Company) and bite registration paste (jet bite, coltene) for interocclusal records during jaw relations. An OPG is shot prior to the treatment, and horizontal condylar guidance (HCG) is traced joining the bony landmarks in a completely edentulous patient seeking complete denture treatment. All the conventional steps for complete denture fabrication up to jaw relation are performed. A facebow transfer is done on a Hanau H2 articulator, and height tracers (extra oral tracing devices) are attached. After satisfactory training, the tracing is performed by the patient, and the interocclusal records are obtained. The articulator is programmed to obtain the value of HCG using protrusive records, which are then compared to the value obtained from OPG. Statistics were carried out to determine angles. Followed by statistical analysis with Pearson correlation to analyze the results (α = 0.01). Results A substantial relationship was discovered between the horizontal condylar inclination between two interocclusal recording materials and the corresponding OPG for both the right (p = 0.0015) and left (p = 0.0007) sides. Conclusion The condylar guidance obtained with jet bite was closer than the condylar guidance value obtained with reinforced wax when compared with the horizontal condylar inclination obtained in OPG by tracing with a mean difference of 10° for polyvinyl siloxane and 20° for reinforced wax in seven subjects evaluated.

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.