Digital Radiography Examination Research Articles

Paediatric Dose AssessmentToward Establishment of National Diagnostic Reference Levels for Digital Radiography Examinations in Iran

Introduction: Paediatric patients deserve special attention because of the higher radiation risks compared with adults. The main purpose of this study is to determine patient dose and diagnostic reference level for Paediatric through Entrance Surface Dose (ESD) calculations in common X-ray examination and to establish Paediatric national DRLs in digital radiography in Iran. Materials and Methods: The study was performed on 5260 patients in 53 X-ray room. They are classified into four age groups, 0>1 year, 1>5 years, 5>10 years and 10>15 years old. Skull (PA), Skull (Lat), Chest (PA), Chest (Lat), Pelvis(AP), Abdomen (AP) digital X-ray examination is done for them. The dosimetry protocol in this study was indirect method to measure Entrance Surface Air Kerma (ESAK). The X-ray tube output for each equipment is measured using RTI solid state detector (Model Barracuda). Finally, the third quarter determined diagnostic reference level. Results: Based on the results of this study, national diagnostic reference levels were established: for example, for age group 0 to 1-year-old: 0.51 mGy for Skull(AP/PA), 0.46 mGy for Skull(Lat), 0.11 mGy for Cervical spine(AP), 0.11 mGy for Cervical spine(Lat), 0.06mGy for Chest(PA), 0.08 mGy Chest(Lat), 0.15 mGy for Thoracic spine(AP), 0.26 mGy for Thoracic spine (Lat), 0.48 mGy for Lumbar spine (AP), 0.74 mGy for Lumbar spine(Lat), 0.47 mGy for Pelvis (AP) and 0.47 mGy for Abdomen (AP). Conclusion: This article has determined wide variations in radiation dose of x-ray examinations among hospitals in Iran. Application of a diagnostic reference levels (DRL) could be a optimization procedure for reducing patients dose. The survey reveals significant variations in the radiological practices.

Comparison of International Caries Detection and Assessment System and digital radiographs for detecting occlusal dental caries: An In vivo Study

Abstract Aim: The aim of the present study was to evaluate the accuracy in the diagnosis of occlusal caries lesion using International Caries Detection and Assessment System II (ICDAS II) and digital radiographs in the primary molars. Materials and Methods: A total of 35 children was selected randomly and recruited for visual ICDAS II and digital bitewing radiographic examination by two independent trained examiners. A total of 249 teeth were examined at D1 (enamel caries lesions) and D3 (dentine caries lesions) thresholds. Results: Sensitivity at D1 for ICDAS II were 95%, and 22.97% for digital radiographs While specificity was 1005 for the both tools. At D3, threshold sensitivity of ICDAS II was 94.%, whereas it was 69% for digital radiographs, while specificity was almost the same for both methods and both D1 and D3 thresholds. Excellent inter- and intra-examiner reliabilities were evident. Conclusions: ICDAS II is better than digital radiographs in detecting carious lesions confined to enamel, and both are equally effective in the detection of dentinal carious lesions.

The National Diagnostic Reference Level in Routine Digital Radiography Examinations in Iran

The National Diagnostic Reference Level in Routine Digital Radiography Examinations in Iran

Optimization of Dose and Image Quality in Full-fiand Computed Radiography Systems for Common Digital Radiographic Examinations

IntroductionA fine balance of image quality and radiation dose can be achieved by optimization to minimize stochastic and deterministic effects. This study aimed in ensuring that images of acceptable quality for common radiographic examinations in digital imaging were produced without causing harmful effects. Materials and MethodsThe study was conducted in three phases. The pre-optimization involved ninety physically abled patients aged between 20 to 60 years and weighed between 60 and 80 kilograms for four common digital radiographic examinations. Kerma X_plus, DAP meter was utilized to measure the entrance surface dose (ESD) while effective dose (ED) was estimated using CALDose_X 5.0 Monte Carlo software. The second phase, an experimental study utilized an anthropomorphic phantom (PBU-50) and Leeds test object TOR CDR for relative comparison of image quality. For the optimization phase, the imaging parameters with acceptable image quality and lowest ESD from the experimental study was related to patient’s body thickness. Image quality were evaluated by two radiologists using the modified evaluation criteria score lists. ResultsSignificant differences were found for image quality for all examinations. However significant difference for ESD were found for PA chest and AP abdomen only. The ESD for three of the examinations were lower than all published data. Additionally, the ESD and ED obtained for all examinations were lower than that recommended by radiation regulatory bodies. ConclusionOptimization of image quality and dose was achieved by utilizing an appropriate tube potential, calibrated automatic exposure control and additional filtration of 0.2mm copper.

Estimating Entrance Skin Dose of Digital Radiography Examination Using Displayed Dose Area Product

Objective: To estimate entrance skin dose (ESD) of digital radiography (DR) examination using displayed dose area product (DAP)Material and Method: The functional relation between calculated ESD using x-ray tube output principle and displayed DAP were investigated. The displayed DAP was obtained from whole body phantom which underwent seven projections: skull anteroposterior (AP), skull lateral (Lat), chest posteroanterior (PA), abdomen AP, pelvis AP, lumbar spine AP and l umbar spine Lat. The estimating results were analyzed and compared with two other methods using one-way analysis of variance.Results: The high relation between the ESD calculated and the displayed DAP were founded with simple equation: ESD=0.0017.DAP+0.1546 (R2=0.88) The mean ESD estimated performed by DR examination with automatic exposure control (AEC) mode using our method, Mcparland method and Kisilewicz method were 1.07, 1.13 and 0.89 whereas without AEC mode were 3.25, 3.45 and 2.60 respectively. There was provided no statistically significant difference between our approach and two other methods (p-value>0.010).Conclusion: The displayed DAP can be used to estimate the ESD.

Clinical and radiographic changes of carpi, tarsi and interphalangeal joints of beef zebu bulls on semen collection regimen

ABSTRACT Osteoarthritis and osteochondrosis are highly correlated to reproductive failure in bulls. This study aimed to evaluate the carpal, tarsal and interphalangeal lesions in beef zebu bulls on semen collection regimen. Twenty-one beef cattle bulls, in a total of forty-one animals, were split into three age-based groups: animals from two to four years old (GI), from more than four to eight years old (GII) and above eight years old (GIII). The clinical findings were conformational changes of limbs, synovial effusion, peripheral venous engorgement of joints and prolonged decubitus. The total population showed moderate clinical manifestation and radiographic score. The GIII presented more severe joint lesions. Carpi and tarsi regions had discrete to difuse osteophytosis, subchondral cysts, cartilaginous flaps, bone incongruence and fragmentation, osteitis, and ankylosis. Interphalangeal joints presented osteophytosis, distal phalanx osteitis and enthesophytosis. The digital radiographic examination allowed full identification of articular lesions and their clinical correspondences, besides the positive correlation between age, body weight and radiographic score.

Dose Evaluation for Common Digital Radiographic Examinations in Selected Hospitals in Pahang Malaysia

Introduction: In digital radiography, radiographers tend to increase exposure factors to acquire an acceptable image quality thereby increasing radiation dose to patients. Regarding this, the present study aimed to re-evaluate the exposure parameters and to ascertain the entrance surface dose (ESD) and effective dose (ED) of posterior-anterior (PA) chest, abdomen, and anterior-posterior (AP) lumbosacral spine radiography. Materials and Methods: This study was conducted on 180 physically able patients with age of 20-60 years and weight of 60-80 kg referred to Hospital Sultan Haji Ahmad Shah (HOSHAS) and Hospital Tengku Ampuan Afzan (HTAA).Image acquisition was performed using digital radiography. The ESD and ED were determined using CALDose_X 5.0 software. Results: The ESD and ED for PA chest were 0.098 mGy and 0.012 mSv in HOSHAS, while in HTAA were 0.161 mGy and 0.021 mSv respectively. Regarding the abdomen, the ESD and ED were 2.57 mGy and 0.311 mSv in HOSHAS and 2.16 mGy and 0.262 mSv in HTAA respectively. For AP lumbosacral spine, the ESD and ED for HOSHAS were 2.65 mGy and 0.222 mSv, while in HTAA were 2.357 mGy and 0.201 mSv respectively. Conclusion: The findings revealed the use of high kVp, automatic exposure control, correct focus image receptor distance, tight collimation and additional filter resulted in a lower ESD. The ESD and ED obtained in this study were comparable with those reported by other studies and lower than the values recommended by the United Nations Scientific Committee on the Effects of Atomic Radiation in 2008.

Chronological Age Estimation Based on Mandibular Third Molar Development from Digital Panoramic Radiograph in a South Kerala Population

Introduction: Tooth development is the best method in estimating the chronological age of young adults. Demirjan’s method has high value of correlation and observer agreement between chronological age and estimated age. Aim of the study: To assess the chronological age based on developmental stages of mandibular third molar using Demirjian’s method. Materials and methods: A retrospective study of 160 radiographs, among subjects in the age group of 9-25 years who underwent digital panoramic radiographic examination during the last 6 months in the Department of Oral Medicine and Radiology, Pushpagiri College of Dental Sciences, Thiruvalla, Kerala, South India. TenmaIes and ten females were selected for each stage of third molar development (n=160). Developmental stage of the mandibular third molar was assessed using Demirjian’s method. Results: The root formation of mandibular third molars is completed (stage H) at the mean age of 21.4 ± 2.5 years and 21.2 ± 3.2years in females and males respectively. At the mean age of 14.6 ± 1.5 and 13.6 ± 1.9years, the formation of inter-radicular bifurcation (Stage E) had started in males and in females. The data showed that males reached the stages at indicated ages earlier than females. Conclusion: Radiological development of the third molar may be a useful biological variable for estimating the age of a person between teens and early 20s.

Infection control and patient discomfort with an alternative plastic barrier in intraoral digital radiography.

(1) To compare the efficacy of a commercially available hygienic sheath and an alternative plastic bag in preventing contamination of the imaging plate during intraoral radiography and (2) to compare patient discomfort when using the hygienic sheath and the plastic bag. 60 sterilized Size 2 imaging plates covered with either the hygienic sheath (n = 30) or the plastic bag (n = 30) were used to simulate digital periapical radiographic examination in 30 volunteer patients. After disinfection, each plate was swabbed. The swabbed medium was then plated on trypticase soy agar and incubated. Bacterial colonies were counted. Patient discomfort was assessed using a visual analogue scale (VAS) score. The comparison of the number of bacterial colonies and VAS scores between the two groups was tested by paired t-test at p < 0.05. There was no significant difference in the number of bacterial colonies between the two groups (p = 0.745). Of all the plates, 10% plates yielded bacterial colonies. The mean count of bacterial colonies for both groups was 10-20 CFU ml-1. However, there was a significant difference between VAS scores for the two systems (p = 0.000). The mean VAS scores (range 0-10) for patient discomfort for the hygienic sheath group and the plastic bag group were 3.03 and 5.33, respectively. Based on the design of this study, the alternative barrier provided similar results to those commercially available. Regarding the type of barrier envelope, the hygienic sheath induced less discomfort than the plastic bag.

English

Background: A study has been carried out in order to evaluate in vivo the diagnostic performance of near-infrared light transillumination (NIRT) compared to digital radiographic examination (RE) in the detection of class II carious lesions. Methods: A total of 114 patients were included, and 2957 proximal surfaces were considered. Surfaces were imaged by means of NIRT and radiographed with a photostimulable phosphor system. NIRT and radiographic images were observed by two blinded operators. Their diagnoses were compared with those made while visiting the patients, when visual-tactile, radiographic and NIRT data were matched by expert operators to obtain the reference diagnoses. Sensitivity, specificity and inter-observer consistency were calculated. Results: Throughout the visits, 395 caries were detected. When investigating without clinical information and in a blind manner, RE performed significantly better than NIRT regarding sensitivity analysis (0.591 vs. 0.456, p<0.001), and NIRT performed significantly better than RE regarding specificity analysis (0.980 vs 0.933, p<0.001). However, NIRT showed sensitivity similar to RE when only enamel caries were concerned. With regard to the agreement between the two observers, NIRT performed significantly better than RE (0.901 for RE analysis, 0.989 for NIRT analysis, P<0.001). A high probability of false positives for enamel caries (95% from 0.699 to 0.791) was observed in RE. NIRT was very likely to detect and correct the erroneous positive diagnosis of enamel carious lesions obtained using RE (95% CI for probability from 0.938 to 0.979). Conclusions: NIRT should be used in caries diagnosis in combination with radiographic images. In fact, NIRT can help to correct a false positive diagnosis of enamel caries. Furthermore, NIRT could be used to detect caries in patients for whom non-urgent radiographic exposition is contraindicated and to monitor enamel caries in medically treated patients. Finally, thanks to its three-dimensional images, NIRT can aid in detecting small caries when performing minorly invasive restorative procedures.

A Study on Patient Gown in Digital Radiography Examination

Background/Objectives: The image quality was degraded due to the image noise in accordance with the performance improvement of diagnostic DR system. This study aims to present and recommend the effect on an image when hospitalized patients undergo the examination without wearing an examination gown in the chest PA test using radiography. Methods/Statistical Analysis: The experiment in this study was conducted by using the DR system of DK Company. In regard to the comparison experiment between the patient gown and the examination gown, Thorax Phantom was utilized. The Phantom specification is RS-111. The image was obtained by utilizing AEC by varying the dose (mAs) and tube voltage (kVp) while putting both the patient gown and the examination gown on the phantom. Then, the gray value of the obtained image was measured based on the 7 points that were to measure the density at the Japan Anti-Tuberculosis Association through the Image J program. Findings: In the case of descriptive statistics, it was found that there was only a small number of the factors that inhibited the quality of an image because the examination gown was closer to the mean value of phantom than the patient gown on the basis of the phantom. As for the analysis in relation to the measurement area, there was a significant difference at the 2 point spot and the 7 point spot in relation to the patient gown and examination gown of phantom in accordance with the tube voltage. As for the correlation analysis, there was a significant difference between the phantom, the patient gown and the examination gown. Hence, there was a relationship between these three groups. The most influencing factor of the DR development is the patient gown or the examination gown. Application/Improvements: It is believed that it would be possible to enhance the quality of an image by conducting an examination with the examination gown and comparing it with the patient gown in the radiography lab.

Brazilian young dental practitioners' use and acceptance of digital radiographic examinations.

PurposeThe aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years.Materials and MethodsDental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05).ResultsA total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations.ConclusionThis study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

Estimating pediatric entrance skin dose from digital radiography examination using DICOM metadata: A quality assurance tool.

To develop an automated methodology to estimate patient examination dose in digital radiography (DR) imaging using DICOM metadata as a quality assurance (QA) tool. Patient examination and demographical information were gathered from metadata analysis of DICOM header data. The x-ray system radiation output (i.e., air KERMA) was characterized for all filter combinations used for patient examinations. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Backscatter factors (BSFs) were calculated from examination kVp. Patient entrance skin air KERMA (ESAK) was calculated by (1) looking up examination technique factors taken from DICOM header metadata (i.e., kVp and mA s) to derive an air KERMA (k air) value based on an x-ray characteristic radiation output curve; (2) scaling k air with a BSF value; and (3) correcting k air for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying a mass-energy attenuation coefficient ratio by ESAK. Patient ESD calculations were computed for common DR examinations at our institution: dual view chest, anteroposterior (AP) abdomen, lateral (LAT) skull, dual view knee, and bone age (left hand only) examinations. ESD was calculated for a total of 3794 patients; mean age was 11 ± 8 yr (range: 2 months to 55 yr). The mean ESD range was 0.19-0.42 mGy for dual view chest, 0.28-1.2 mGy for AP abdomen, 0.18-0.65 mGy for LAT view skull, 0.15-0.63 mGy for dual view knee, and 0.10-0.12 mGy for bone age (left hand) examinations. A methodology combining DICOM header metadata and basic x-ray tube characterization curves was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology will allow a knowledgeable user the means to establish an automatable dose reporting program for DR and perform patient dose related QA testing for digital x-ray imaging.

Patient dose monitoring in Dubai in radiography and interventional procedures.

This paper presents ongoing actions in Dubai on patient dose monitoring in digital radiographic examinations, mammography, interventional procedures, and dental radiological procedures. The aim of Dubai Health Authority (DHA) is to move towards the establishment of local diagnostic reference levels. DHA has participated in national and regional projects under the umbrella of the International Atomic Energy Agency. The need for local radiation protection educational programmes and wider patient dosimetry monitoring and recording emerged from this work.

Spontaneous Bone Regeneration After Enucleation of Large Jaw Cysts: A Digital Radiographic Analysis of 44 Consecutive Cases.

This study evaluated the healing in cystic defect of the jaw to substantiate our understanding of spontaneous bone healing after enucleation of jaw cysts subjectively and with analysis of digital postoperative panoramic radiographs. Fourty four consecutive patients reporting to the Department of Dental and Oral Surgery, during the period between 2008-2012 having maxillary and mandibular cysts treated by either surgical enucleation or by marsupialization followed by enucleation were evaluated for subsequent bone formation at the site of cystectomy defect by subjective clinical examination along with digital radiographic examination. Postoperative clinical and radiographic examinations were performed at 6,9,12, and 24 months. Bone regeneration was evaluated by reduction of the size of residual cavities at the cystectomy defect using digital orthopantomogram. Out of 44 patients 15 patients completed two years of follow-up with all the patients having 6 months follow-up. The maximum size of the cystic pathology was 150.40mm and minimum of 14.73mm at the time of presentation (average size of 58.16mm). Twenty patients were diagnosed with odontogenic keratocyst, with one patient having multiple OKC associated with Gorlin Goltz Syndrome, 17 patients had dentigerous cyst, 5 had Radicular cyst; solitary bone cyst and globulomaxillary cyst formed one each. Uneventful healing and spontaneous filling of the residual cavities were obtained in all cases. The digital analysis of the postoperative radiographs showed mean values of reduction in size of the residual cavity of 25.85% after 6 months, 57.13% after 9 months, 81.03% after one year and 100% after two year. Spontaneous bone regeneration can occur after surgical removal of jaw cysts without the aid of any graft materials even in large cystic cavity sufficiently surrounded by enough bony walls. This simplifies the surgical procedure, decreases the overall cost of surgery, and reduces the risk of postoperative complications associated with grafting.

Comparison of diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions

Introduction: Accurate diagnosis of periapical lesions may be necessary not only to predict the treatment outcome but also to decrease the incidence of root canal treatment failure. Ultrasound imaging is an easy, reproducible technique, which is based on the evaluation of reflected echoes and has the potential to differentiate the periapical lesions. Aim: To compare the diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions. Materials and Methods: Thirty patients aged between 20 and 40 years, presenting with well-defined periapical radiolucencies in relation to anterior maxillary or mandibular teeth, indicated for extraction or periapical surgery were subjected to conventional and digital radiographic examination by paralleling technique followed by ultrasonological examination. Three observers (A, B, C) gave their radiographic diagnosis twice at an interval of 2 weeks. A sonologist assessed the size, contents, echogenicity and vascular content of the lesions. The diagnosis was compared with histopathological examination of tissues obtained by extraction or periapical surgery. Results: The diagnostic accuracy of ultrasound imaging was 83.33%, which was higher than conventional radiographic examination by all observers (53.33-76.66%) and digital radiographs by observers A and B (70-80%). Conclusion: Our study revealed that ultrasound with color Doppler was an efficient tool for diagnosing periapical lesions as it had better diagnostic accuracy than conventional and digital radiography.

Evaluation of Entrance Skin Radiation Exposure Dose for Pediatrics Examined by Digital Radiography at Asser Central Hospital-KSA

Assessment of entrance skin doses for patients in Digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. We measured the entrance skin dose (ESD) received by 50 pediatrics undergoing 12 types of diagnostic X-ray examination at Radiology Department of Asser Central Hospital-KSA. The entrance skin dose ESD was determined via measurements parameters: focus to skin distance (FSD), tube current (mAs) and tube voltage (kV) in arithmetical equation. The mean ± SD for ESDs were found to be 0.16 ± 0.03, 0.21 ± 0.01, 0.63 ± 0.26, 0.55 ± 0.09, 0.15 ± 0.05, 0.27 ± 0.06, 0.41 ± 0.19, 0.46 ± 0.18, 0.46 ± 0.12, 0.20 ± 0.02, 0.39 ± 0.01, 0.29 ± 0.03, for PA chest, foot, AP pelvis, PA skull, PA hand, AP arm, ankle, AP shoulder, abdomen, forearm, AP femur, AP elbow consequently. Our study is considered as an attempt to evaluate the ESDs received by digital radiographic x-ray machine for children aged between 2 - 15 years old, taking in our considerations number of other variables. The mean ESD values obtained are found to be within the standard reference. The data obtained may add to the available information in national records for general use. It may provide guidance on where efforts on dose reduction will need to be directed to fulfill the requirements of the optimization process and serve as a reference for future researches.

Age estimation using lower permanent first molars on a panoramic radiograph: A digital image analysis.

Objective:A study was carried out to analyze the efficacy and practical application for age estimation using digital panoramic radiograph to exploit image analysis to obtain metric measurement of morphological parameters of permanent mandibular first molar on Sulaimani population.Materials and Methods:In the present study a population of known age and sex was studied and subjected to digital panoramic radiographic examination. The correlation between the reduction of coronal pulp cavity and chronological age was examined in a sample of 96 individuals distributed into four age groups: 20-29 years (29 cases), 30-39 years (29 cases), 40-49 years (26 cases) and 50-59 years (12 cases). The height (mm) of the crown (CH = coronal height) and the height (mm) of coronal pulp cavity (CPCH = coronal pulp cavity height) of 96 of first molars from all subjects was measured. The tooth–coronal index (TCI) after Ikeda et al. was computed for each tooth and regressed on real age.Results:ANOVA was used to show the strength of relation between the age and TCI (P = 0.0000). The correlation coefficient (r2) was 0.49, which mean there is strong negative linear regression between age and TCI with the r2, regarding predicting age using TCI value, after the following equation calculated, Predicted age = 3.78 – (0.064 TCI) showed that there is no significant difference between real age and estimated age.Conclusion:There is a strong negative liner relationship between TCIs of mandibular first molars with chronological age of Sulaimani population, and age of individuals can therefore be estimated with a good degree of accuracy using regression equations.

The utility of the electric mallet.

The aim of this study was to evaluate the efficiency of electrical mallet for tooth extraction evaluating the integrity of fresh sockets walls. From July 2009 to February 2012, 427 hopeless teeth were extracted in 156 patients: 96 males and 60 females, with a mean age of 53.2 ± 26.4 years. Two hundred fifty teeth were extracted from the maxilla and 177 from the mandible. Extractions were performed using an electrical mallet. It pushed blade in a longitudinal movement along central axis, moving up and down toward the periodontal ligament space in a repetitive manner, providing a driving mechanism of longitudinal movements. Intraoral digital radiographic examinations were performed before and immediately after dental extractions to evaluate the lamina dura setting. No fracture or loss of cortical bone plate was observed in fresh sockets of teeth extracted by electrical mallet. All the alveoli revealed full soft tissue secondary healing 2 weeks after complete root extraction. During the healing period, there were no signs of inflamed tissue or exposed bone in any of the cases. As reported in this clinical study, maximum preservation of the alveolar housing and related gingival structures may be achieved following assisted atraumatic tooth extraction by electrical mallet.

Coronal pulp biomarker: A lesser known age estimation modality

Introduction: The evolving state of art digital technology currently available is opening new avenues in forensic odontology for age estimation methods which are subject to debate in terms of accuracy and precision. A study was carried to analyze efficacy and practical application for age estimation using digital panoramic radiographs on South Indian population. Aims and Objectives: 1. To study reduction of coronal pulp chamber using Tooth Coronal Index (TCI) on panoramic radiographs and correlate with chronologic age. 2. To establish accuracy of digital panoramic radiographs as a simple, non-invasive tool. Materials and Methods: The study illustrates the potential value of a little known aging method. The study groups comprised a total of 100 subjects of both sexes in age range of 20 and 60 years each who were subjected to panoramic radiography. A panoramic radiographic examination using digital panoramic machine was conducted on selected individuals. The TCI was calibrated using AGFA computer software for accuracy and precision. The values obtained were subjected to regression analysis, results calculated and correlated with chronologic age. In the present study a population of known age was studied and subjected to digital panoramic radiographic examination. The correlation between reduction of coronal pulp cavity and chronological age was examined. TCI was computed for each tooth and regressed on real age. Statistical Analysis Used: Pearson correlation co-efficient was used to find the significance of relationship between age and TCI. Regression analysis has been used for predicting age using TCI for premolar and molar. Inaccuracy and bias have been determined to assess the precision of prediction equations. Results and Conclusion: Prediction potential of TCI comes down for ages above 50 years and is comfortably good below 50 years without much difference between premolars and molars. This study demonstrates the potential value of TCI for age estimation.