F-speed Film Research Articles

Panduan Pelaksanaan Pemeriksaan Radiografi Kedokteran Gigi Pada Pasien Anak

Background: Dental radiographic examinations are diagnostic tool in oral and dental treatment, including in children. The use of radiation exposure in children is such a challenge for dental practicioners, either about the radiation safety or the patient management. Good quality radiograph should be obtained with minimal radiation and in condition of pediatric patients that sometimes are uncooperative. Literature review: Children have increased risk of disease than adults since their cells are more sensitive to radiation. Therefore dental radiography examinations in children should be performed according recommended steps as following: select radiographic technique for individual’s needs not for routine, choose the fastest image receptor, always use tyroid collar, collimate beam to area of interest, minimize exposure factors. Type of radiographic should be selected as indications. E-speed film, F-speed film, and digital sensor can reduce radiation dose. Tyroid collar and collimator are used for protect healthy tissue. Exposure factors should be minimized by decreasing exposure time. Several modification techniques may be needed to handle unique character of pediatric patients. Communication with “tell, show, do” technique should be undergone to manage patients. Modified radiographic techniques may be helpful to gain patient cooperation, such as Lollipop radiographic technique as desensitization technique, reverse bitewing technique, extraoral periapical technique, panoramic radiography for patient who refused intraoral film and last choice is anestethic. Reverse bitewing technique and extraoral periapical technique can be used to handle gagging reflex. Conclusion: The important issues of radiographic examination in children are about radiation safety and patients management to obtain good quality radiographs. Radiographic examination must have advantages greater than risk of radiation exposure in children. “Tell, show, do” communication technique and radiographic technique modification are part of management principle of children to gain patient cooperation.

Comparison of the accuracy of conventional and digital radiography in root canal working length determination: An in vitro study

Background. Digital radiography has widespread use in endodontics. Determining a correct working length is vital for a proper endodontic therapy. The aim of this study was to compare the accuracy of conventional and digital radiographic techniques for root canal working length determination. Methods. After determining the real working lengths of 50 permanent maxillary central incisors (gold standard), the conventional (E- and F-speed films) and digital (CCD, PSP) images were obtained using the parallel technique. The mean registered working length of each modality was compared with the other and with the gold standard using one-way ANOVA at P<0.05. Results. No significant difference was found between the recorded working length values using the conventional and digital radiographic techniques (P=0.828). Conclusion. Within the limitations of this study, it was concluded that there was no difference between the measurement accuracy of CCD, PSP and conventional imaging techniques in root canal working length determination.

Effect of Different Tube Potential Settings on Caries Detection using PSP Plate and Conventional Film.

To compare intraoral Phosphor Stimulable Plate digital system and intraoral film using different tube settings on incipient proximal caries detection. Five blocks, with five teeth each, were radiographically examined using phosphor plates and F-speed films. The images were acquired in 07 different tube potentials from 50-80 kV. The films were digitized. Three oral radiologists scored the images for the presence of caries using a 5-point rating scale. The areas under ROC curve were calculated. The influence of tube kilovoltage was verified by ANOVA and pair wise comparisons performed using Tukey test. Mean ROC curve areas varied from 0.446-0.628 for digital images and 0.494-0.559 for conventional images. The tube setting of 70 kV presented the best result both for digital and conventional images. Considering the image type separately, 70 kV scored highest followed by 75 and 65 kV for digital images (p=0.084). For conventional image modality, even though 70 kV presented the best result, it did not differ significantly from 80 kV, not differing from 60 and 55 kV, which did not differ from 75, 65 and 50 kV (p=0.53). Phosphor plate digital images seem to be more susceptible to tube setting potential variations then digitized film images.

Intraoral Radiology in General Dental Practices – A Comparison of Digital and Film-Based X-Ray Systems with Regard to Radiation Protection and Dose Reduction

The purpose of this study was to gain insight into the distribution and application of digital intraoral radiographic techniques within general dental practices and to compare these with film-based systems in terms of patient dose reduction. 1100 questionnaires were handed out to general dental practitioners. Data was analyzed with respect to the type of system by using descriptive statistics and nonparametric tests, i.e. Kruskal-Wallis, Mann-Whitney and chi-square test (SPSS 20). 64% of the questioned dentists still use film-based radiology, 23% utilize storage phosphor plate (SPP) systems and 13% use a charge-coupled device (CCD). A strong correlation between the number of dentists working in a practice and the use of digital dental imaging was observed. Almost 3/4 of the film users work with E- or F-speed film. 45% of them refuse to change to a digital system. The use of lead aprons was popular, while only a minority preferred thyroid shields and rectangular collimators. A fourfold reduction of exposure time from D-speed film to CCD systems was observed. Due to detector size and positioning errors, users of CCD systems take significantly more single-tooth radiographs in total. Considering the number of radiographs per patient, there is only a slight tendency towards more X-rays with CCD systems. Up to image generation, digital systems seem to be as or even more difficult to handle than film-based systems, while their handling was favored after radiographic exposure. Despite a slight increase of radiographs taken with CCD systems, there is a significant dosage reduction. Corresponding to the decrease in exposure time, the patient dose for SPP systems is reduced to one half compared to film. The main issues in CCD technology are positioning errors and the size of the X-ray detectors which are difficult to eliminate. The usage of radiation protection measures still needs to be improved. ► Responsible use of digital intraoral radiology results in a significant dose reduction in everyday practice. ► The ALARA principle is only achieved by strict implementation of dose-reducing methods. ► The efforts to use dose-reducing devices must be increased.

Comparison between intraoral indirect and conventional film-based imaging for the detection of dental root fractures: anex vivostudy

Digital intraoral radiographic systems have been rapidly replacing conventional dental X-ray films for diagnosis of dental diseases. Current scientific literature supports the use of these digital systems for the detection of dental caries, periodontal bone loss, and periapical pathologies. However, relatively few studies have been published addressing the detection of dental root fractures. The purpose of this study was to compare the intraoral F-speed film (Insight) with two photostimulable phosphor (PSP) indirect digital systems (ScanX and Digora Optime) for the detection of simulated dental root fractures. Ten raters evaluated images acquired from 10 dry human cadaver mandibles under optimal viewing conditions. These data were analyzed by a 5-point receiver operating characteristic curve analysis for statistical differences. Sensitivity and specificity of these systems were also assessed. Since statistically significant difference between the systems was not observed, the results of this study agreeably support indirect digital PSP plates as an alternative to the evaluated conventional film for the detection of dental root fractures.

In vitro Comparison of Conventional Film and Direct Digital Radiography in Proximal Caries Detection

Introduction: Various systems for intraoral digital radiography have been available as an alternative to film-based radiography. In consideration of several advantages of digital radiography such as less patient absorbed dose, manipulation of im- age quality and elimination of processing, it has been extensively used in different fields of denti- stry in recent years. The purpose of this study was comparison of conventional film and digital radiography in the proximal caries diagnosis. Materials and Methods: In this in vitro study, 60 extracted premolar teeth were selected and mounted in acrylic blocks. The teeth were radio- graphed using F-speed film and a complementary metal oxide semiconductor digital sensor (CMOS). Two observers evaluated interproximal surfaces for detection of presence and extent of caries. True caries depth was determined by his- tological examination. The diagnostic accuracy of each radiographic system were assessed by means of receiver operating characteristic curve (ROC) analysis. Results: There was no significant difference be- tween two imaging modalities. The AZ values in cases without caries and dentinal caries were greater than caries restricted to enamel and Den- tino Enamel Junction (DEJ). The differences among observers also were not statistically sig- nificant. Conclusion: Both imaging modalities were com- parable in the detection of proximal carious le- sions.

Diagnostic accuracy of Digora Optime storage phosphor plates for proximal subsurface demineralization: effect of different exposure times

The aim of this study was to compare the diagnostic accuracy of F-speed film and storage phosphor plate (SPP) exposed with different exposure times for the detection of artificial enamel subsurface demineralization. Standard enamel windows of extracted premolars were exposed to a demineralizing solution. All teeth were radiographed before and after acid application with F-speed films and SPPs. Films were exposed for 0.25 seconds and SPPs were exposed using 4 exposure times. Receiver operating characteristic analysis was used for diagnostic accuracy (A(z)). Significant differences were obtained among A(z)s of 0.08- versus 0.12-seconds and 0.10- versus 0.12-second exposed SPPs (P < .05). A(z)s of films were higher than the SPPs exposed with 0.08, 0.10, and 0.12 seconds (P < .05). No difference was found between the A(z)s of the 2 systems when SPPs were exposed for 0.16 seconds (P > .05). Diagnostic accuracy of films and SPPs was not impaired when exposure time was 36% reduced for the latter; however, diagnosis was impaired when reduced 52%.

Compliance of Iranian dentists with safety standards of oral radiology

Dentists use radiographs in their daily practice. Their knowledge and behaviour towards radiographic examination can affect patients' exposure to radiation. The aim of this study was to survey the knowledge and behaviour of Iranian dentists regarding oral radiology safety standards. 1000 questionnaires were given to the participants of the 48th Annual Congress of the Iranian Dental Association, of which 700 were returned. The participants were asked about demographic data, primary knowledge of radiation protection, selection criteria, radiographic equipment and technique, methods of patient and personnel protection and management of radiographic waste. Descriptive analysis of data was performed. 44% of respondents said the initial radiograph they took was of the periapical view of a limited area. 12% preferred the periapical paralleling technique. F-speed film was used by 9% and E-speed film by 62%. Only 2% had digital receptors. Proper exposure time was selected by 26.5%. The use of long and rectangular collimators was 15% and 6%, respectively. 34% occasionally covered their patients with both thyroid shields and lead aprons. 36% used the position and distance rule correctly for their own protection. Proper disposal of the used processing solutions and the lead foils were done by only 1% and 3%, respectively. It can be concluded that the majority of dentists in the study group did not select the proper method, material and equipment in order to minimize the exposure of their patient to unnecessary radiation in dental radiography.

Assessment of vertical root fractures using three imaging modalities: cone beam CT, intraoral digital radiography and film

The aim of this study was to assess the accuracy of cone beam CT (CBCT) in detecting vertical root fractures and to compare the accuracy with images from an intraoral sensor and from conventional intraoral film. 60 extracted, single-rooted human teeth were divided equally into two groups: a control group of 30 teeth and an induced fracture group of 30 teeth. All teeth were randomly placed into sockets in six dry mandibles. Each tooth was imaged by three modalities: CBCT, intraoral digital radiography and intraoral F-speed film. Three beam angulations (an orthogonal projection and additional projections with ± 20° horizontal shifts of the central ray) were used when radiographs were made using film and a digital sensor. Three oral and maxillofacial radiologists evaluated the presence of root fractures twice in each image modality using a five-point confidence rating scale. Areas under receiver operating characteristic curves (A(z)) were computed for each observer and modality and were tested for statistical differences using the Kruskal-Wallis test. There was no statistical difference in the performance of the three modalities (mean of A(z) values: CBCT = 0.811, film = 0.797 and sensor = 0.775; p = 0.771). There was no significant difference between intraoral film, a high-resolution complementary metal oxide semiconductor digital imaging system and CBCT in detecting vertical root fractures in mandibular single-rooted teeth.

Detection of experimentally induced root fractures on digital and conventional radiographs: an in vitro study

This study compared the diagnostic accuracy of digital radiographic images with conventional radiographs for the detection of experimentally induced root fractures. Horizontal fractures were induced by a mechanical force to the root of 15 single rooted teeth. Vertical fractures were induced in 15 single rooted teeth and 15 molars, respectively, by disk cutting. The teeth were mounted in dried mandibles and were radiographed with the parallel technique using a CCD-based Planmeca imaging system and F-speed films. Seven observers recorded their findings and then 2 pairs of them examined the same images together. Az values expressed the diagnostic accuracy of the imaging systems and the degree of agreement was estimated using the Cohen's kappa statistic. The areas under the ROC curves (Az) in single rooted teeth were 0.61 for conventional radiography and 0.64 for digital radiography. Digital imaging system did not perform significantly better than conventional one (p>0.01). Digital radiographs (Az: 0.72) provided higher detection accuracy in molars than conventional images (Az: 0.51) (p=0.0102). The digital images scored higher kappa values with narrower range than conventional. Observers in pairs did not perform significantly better than individually. The results were not affected by the observers but were affected by the cases (p<0.001). Digital images were equivalent to F-speed films for the detection of root fractures in single rooted teeth. The digital system performed significantly better than the conventional in detecting root fractures in molars.

Does a Combination of Two Radiographs Increase Accuracy in Detecting Acid-induced Periapical Lesions and Does It Approach the Accuracy of Cone-Beam Computed Tomography Scanning?

Introduction The purpose of this study was to determine whether the use of a combination of 2 images (storage phosphor plates [SPPs] and F-speed films [Eastman Kodak, Rochester, NY]) with a 10° difference in horizontal beam angulation resulted in better detectability of chemically created periapical defects than when only 1 image was used and whether a detectability as good as that achieved by limited cone-beam computed tomography (LCBCT) scanning could be achieved. Methods Lesions were created by 1, 1.5, and 2 hours of acid application apical to extracted teeth in jaw specimens. After repositioning, teeth were radiographed with Accu-I-Tomo LCBCT, Digora Optime SPP system, and F-speed films. The SPPs and films were exposed at 0° and 10° horizontal angulations. The diagnostic accuracy (Az) was compared using 2-way analysis of variance; pair-wise comparisons were performed using the post hoc t test. Kappa was used to measure interobserver agreement. Results A combination of 2 exposures with a 10° difference in horizontal angulation caused an increase, although not statistically significant, in the accuracy of both films and SPPs for all acid durations ( P > .05) compared with when only 1 exposure was used. The accuracy did not approach that of LCBCT. Conclusions Using a combination of 2 exposures instead of 1 did not significantly increase the accuracy in detecting acid-induced lesions at the apices of single-rooted premolars. The accuracy of LCBCT was superior.

Diagnostic accuracy of proximal enamel subsurface demineralization and its relationship with calcium loss and lesion depth

The aim of this study was to determine the relationship between the amount of calcium loss, lesion depth, and the accuracy of storage phosphor plate (SPP) and film radiographs for the detection of artificial proximal demineralization. Standard enamel windows of extracted premolars were exposed to a demineralizing solution for 60 h, 80 h, 100 h and 120 h. Solutions were analysed for calcium concentration by atomic absorption spectrometer and the lesion depths were calculated by a specific formula. All teeth were radiographed with SPPs and F-speed films before and after acid application. Images were evaluated by five observers. Stereomicroscopic and scanning electron microscopic (SEM) observations were carried out to visualize enamel surfaces after acid exposure. Receiver operating characteristic analysis was used for diagnostic accuracy (A(z)). A(z)s were compared with factorial analysis of variance and t-tests. The relationship between A(z)s and lesion depths was determined with Pearson's correlation test. Strong positive correlation was found between A(z)s of both radiographic methods and lesion depths. No difference was found between the A(z)s of two radiographic systems for any of the demineralization durations (p > 0.05). Pair-wise comparisons revealed no significant difference in A(z)s of SPPs (p > 0.05), while significant differences were obtained for the A(z)s of films for different demineralization periods (p < 0.05). Stereomicroscopic and SEM observations confirmed demineralizations from superficial to deeper layers of enamel. Subsurface enamel demineralization was not accurately detectable with either storage phosphor plates or F-speed films. The amount of calcium loss and the depth of demineralization have a strong relationship with diagnostic accuracy with a significant effect particularly on F-speed films.

Effects of developer exhaustion on DFL Contrast FV-58 and Kodak Insight dental films

The aim of this study was to compare the properties of the DFL Contrast FV-58 F-speed film (DFL Co., Rio de Janerio, Brazil) with the Kodak Insight E/F speed film (Eastman Kodak, Rochester, NY) in fresh and exhausted processing solutions. The parameters studied were the speed, average gradient and latitude. Five samples of each type of film were exposed under standardized conditions over 5 weeks. The films were developed in fresh and progressively exhausted processing solutions. Characteristic curves were constructed from values of optical density and radiation dose and were used to calculate the parameters. An analysis of variance was performed separately for film type and time. DFL Contrast FV-58 film has a speed and average gradient that is significantly higher than Insight film, whereas the values of latitude are lower. Exhausted processing solutions were not significant in the parameters studied. DFL Contrast FV-58 film has stable properties when exhausted manual processing solutions are used and can be recommended for use in dental practice, contributing to dose reduction.

The effect of exposure reduction on the diagnosis of caries: An ex vivo comparison of film and a CMOS digital imaging system

Objectives: To determine the effect on caries diagnosis of exposure reduction on intraoral digital radiographs compared with optimally exposed film images. Materials and Methods: F-speed film radiographs of 61 extracted molars and premolars were made with optimal exposure parameters. The teeth were radiographed using a complementary metal oxide semiconductor (CMOS) digital system with exposures equal to 50%, 30%, 20%, 10%, and 5% of the film exposure. Five observers, who were permitted to adjust brightness and contrast on the digital images, scored the proximal and occlusal surfaces for the presence of caries using a 5-point confidence scale. Areas under receiver operating characteristic (ROC) curves represented accuracy of caries detection. Sensitivity and specificity were also calculated. The significance level was P = 0.05. Results: All digital images resulted in lower diagnostic accuracy than film images for all lesions (P ≤ 0.036) and for caries in enamel only (P ≤ 0.030). With dentin caries, there were no significant differences between film and any digital radiographs (P ≥ 0.065) except the 5% exposures (P ≤ 0.034). Digital radiographs of 5% of the exposure of film were significantly poorer than all other exposure categories (P ≤ 0.014) except for the 10% exposures for accuracy for all lesion sizes and for dentin lesions only. Exposures at 10% and 20% resulted in lower sensitivity scores for enamel caries, while 50% exposures were associated with the poorest specificity. Conclusions: Exposures of 30% of optimal F-speed film exposure settings appear to balance acceptable levels of accuracy, sensitivity, and specificity for caries detection. Observer-controlled enhancements were ineffective at extremely high and low exposures.

Detectability of chemically induced periapical lesions by limited cone beam computed tomography, intra-oral digital and conventional film radiography

Our aim was to compare the Accu-I-Tomo (3DX), the Digora Optime image plate system and F-speed film in detecting chemically created apical lesions. Lesions were created by applying perchloric acid apical to extracted teeth in jaw specimens for 1, 1.5 or 2 h. After being repositioned, teeth were radiographed with Accu-I-Tomo limited cone beam CT (LCBCT), Digora Optime storage phosphor plates (SPP) and F-speed films. Six observers scored the presence of lesions using a five-grade scale. The accuracy of each observer and modality was assessed through receiver operating characteristic (ROC) analysis and A(z) values were compared using two-way ANOVA. Pairwise comparisons of imaging systems were carried out using the Mann-Whitney U-test. Differences in A(z) values were compared using Friedman and Dunn's tests. Kappa (kappa) was used to measure interobserver agreement. The A(z) values were larger for LCBCT than for SPP and film for all acid durations. For 1 h of acid duration a significant difference was found between LCBCT and film (P = 0.02) and between LCBCT and SPP (P = 0.0043), For 1.5 h a significant difference (P = 0.006) was found between LCBCT and SPP only. For 2 h acid duration, there was no significant difference between LCBCT and film or SPP (P>0.05). Between SPP and film no significant difference was found for any acid duration (P>0.05). kappa ranged between fair and moderate for LCBCT and between slight and fair for SPP and film. LCBCT images provided better than or similar detectability as film and SPP images of chemically created periapical lesions.

Comparison of visual inspection and different radiographic methods for dentin caries detection on occlusal surfaces

The aim of the present study was to assess the validity of the digital phosphor plate radiographic technique (Gendex Dental Systems) on occlusal surfaces in comparison with visual examination and conventional E- and F-speed films. The study material consisted of 54 non-cavitated third molars with a range of appearances, including apparently sound surfaces. Each surface was visually examined (VI) according to the criteria established by Ekstrand et al. Three radiographic images (E-speed, F-speed, digital phosphor plate film) were taken of each molar. The standardized radiograph technique used an alignment fixture to reproduce the focus-to-object distance as well as the object-to-film distance. Afterwards each tooth was cut into sections in the buccolingual direction with a microtome saw, and caries extension was assessed using light microscopy (LM) and microradiography (MR). The statistical analysis included the calculation of sensitivity (SE), specificity (SP) and A(z) values. The following validity parameters were found for the tested diagnostic methods on the dentin caries level: VI/LM, 68.0 SE/93.1 SP/0.698 A(z); VI/MR, 68.2/87.5/0.751; E-speed/LM, 76.0/78.6/0.637; E-speed/MR, 77.3/74.2/0.681; F-speed/LM, 64.0/67.9/0.507; F-speed/MR, 68.2/67.7/0.594; Gendex/LM, 60.0/85.7/0.629; and Gendex/MR, 59.1/80.6/0.586. The methods used showed different levels of validity: E- and F-speed films were linked to higher sensitivity values, whereas a higher specificity was recorded for the tested imaging plate system. In accordance with the diagnostic performance, the digital system can be recommended for practical use and potentially help prevent overtreatment thanks to its high SP.

Detection of Artificial Occlusal Caries in a Phosphor Imaging Plate System with Two Types of LCD Monitors Versus Three Different Films

The aim of this study was to determine diagnostic performance of a storage phosphor plate system Digora Optime (Soredex, Helsinki, Finland) with two types of LCD monitor in the detection of artificial caries when compared to Ultraspeed (D), Ektaspeed Plus (E), and Insight (F) radiographic films. Seventy extracted human molars-with artificial caries-were radiographed under identical standardized conditions using (1) a storage phosphor plate system Digora (Soredex, Helsinki, Finland), (2) Insight, (3) Ektaspeed Plus, and (4) Ultraspeed (Carestream Health Inc, Rochester, NY). All digital images and radiographs were examined by three observers for the presence or absence of artificial caries using a five-point confidence scale. Digital images were evaluated both on a LCD computer monitor (Philips 170S, Holland) and medical monitor-3 megapixel monochrome display (Me355i2, Totoku, Tokyo)-with brightness and contrast enhancement. Observer responses were evaluated using ROC analysis and other measurements for diagnostic accuracy. Storage phosphor images with medical monitor demonstrated higher mean A (z) values (0.70 +/- 0.08) than digital images with computer monitor and conventional films. Storage phosphor images with medical monitor presented the highest score, 0.97, 0.90, 0.94, for each observer, respectively. Also, true positive observations (0.82) and positive likelihood ratios (2.71) were higher in enhanced storage phosphor images with medical monitor. Caries detection of mechanically created lesions by experienced radiologists is roughly comparable when examining D-speed film images and Digora images on both the computer and medical LCD monitors, and appears to be poorer on E- and F-speed film images.

Patient Risk Related to Common Dental Radiographic Examinations: The Impact of 2007 International Commission on Radiological Protection Recommendations Regarding Dose Calculation

In 2007, the International Commission on Radiological Protection (ICRP) revised estimates of the radiosensitivity of tissues including those in the maxillofacial region. The authors conducted a study to reassess patients' risk related to common dental radiographic exposures using the 2007 ICRP recommendations. The authors used a tissue-equivalent head phantom to measure dose. They calculated effective doses by using both 1990 and revised 2007 ICRP recommendations. Effective dose is a calculation that takes into consideration the different sensitivities of organs to long-term effects from ionizing radiation. It is the preferred method for comparing doses between different types of exposures. Effective doses (per the 2007 ICRP) in microsieverts were as follows: full-mouth radiographs (FMX) with photo-stimulable phosphor (PSP) storage or F-speed film with rectangular collimation, 34.9 microSv; four-image posterior bitewings with PSP or F-speed film with rectangular collimation, 5.0 microSv; FMX using PSP or F-speed film with round collimation, 170.7 microSv; FMX with D-speed film and round collimation, 388 microSv; panoramic Orthophos XG (Sirona Group, Bensheim, Germany) with charge-coupled device (CCD), 14.2 microSv; panoramic ProMax (Planmeca, Helsinki, Finland) with CCD, 24.3 microSv; posteroanterior cephalogram with PSP, 5.1 microSv; and lateral cephalogram with PSP, 5.6 microSv. These values are 32 to 422 percent higher than those determined according to the 1990 ICRP guidelines. Although radiographs are an indispensable diagnostic tool, the increased effective doses of common intraoral and extraoral imaging techniques are high enough to warrant reconsideration of means to reduce patients' exposure. Clinicians can reduce patients' dose substantively by using digital receptors or F-speed film instead of D-speed film, rectangular collimation instead of round collimation and radiographic selection criteria.

A Comparison of Five Radiographic Systems to D-Speed Film in the Detection of Artificial Bone Lesions

The purpose of this study was to compare three direct digital sensors (Kodak 6100 [Rochester, NY], Schick CDR [Long Island City, NY], and Dexis PerfectSize [Alpharetta, GA]), a phosphor plate system (OpTime; Milwaukee, WI), and F-speed film to standard D-speed film in the detection of artificial bone lesions prepared in mandible bone sections. Artificial bone lesions were prepared at varying depths in the cortical bone. Radiographs were randomly presented to nine different observers. Logistic regression analysis indicated significant differences in lesion detection among the radiographic systems at the mean percentage of cortical bone remaining. The Kodak filtered, Schick filtered, OpTime unfiltered, Schick unfiltered, and Dexis filtered images were significantly better at lesion detection compared with D-speed film.

Measurement accuracy and perceived quality of imaging systems for the evaluation of periodontal structures

The aim of this study was to compare the subjective diagnostic quality of F-speed film images and original and enhanced storage phosphor plate (SPP) digital images for the visualization of periodontal ligament space (PLS) and periapical (PB) and alveolar crestal bone (CB) and to assess the accuracy of these image modalities for the measurement of alveolar bone levels. Standardized images of six dried mandibles were obtained with film and Digora SPPs. Six evaluators rated the visibility of anatomical structures using a three-point scale. Alveolar bone levels were measured from the coronal-most tip of the marginal bone to a reference point. Results were compared by using Friedman and Wilcoxon signed-ranks tests. The kappa (kappa) statistic was used to measure agreement among observers. The measurements were compared using repeated measures analysis of variance and Bonferroni tests (P = 0.05). A paired t test was used for comparison with true bone levels (P = 0.05). Enhanced SPP images were rated superior, followed by film and then the original SPP images, for the evaluation of anatomical structures. The value of kappa rose from fair to substantial after the enhancement of the SPP images. Film and enhanced SPP images provided alveolar bone lengths close to the true bone lengths. Enhancement of digital images provided better visibility and resulted in comparable accuracy to film images for the evaluation of periodontal structures.