Enrique Platin

A comparison of kodak ektaspeed plus film and the siemens sidexis digital imaging system for caries detection using receiver operating characteristic analysis

OBJECTIVE To evaluate the accuracy of proximal caries detection comparing enhanced and unenhanced Siemens Sidexis CCD-based digital images with Ektaspeed Plus films utilizing receiver operating characteristic analysis. STUDY DESIGN Sixty extracted teeth (24 posterior and 36 anterior) were imaged under identical standardized geometric and exposure conditions. Six observers, using a 5-point confidence scale, rated 120 proximal surfaces for the presence or absence of carious lesions by means of three image modalities: (1) observer enhanced and (2) unenhanced Sidexis displays, and (3) Ektaspeed Plus films. The ground truth was determined by microscopic analysis of ground sections. Receiver operating characteristic curves were generated with calculated areas (AZ) analyzed with analysis of variance for effect of reader, reading, and modality. RESULTS Analysis of variance demonstrated significant differences among readers, readings and modalities (mean square values of 0.012, 0.005, 0.004, F ratios of 13.604, 5.329, 5.100; p = values of 0.001, 0.043, and 0.030, respectively). Post-hoc paired comparisons of modalities using Tukeys statistic demonstrated that only film and enhanced Sidexis images were different from each other (p = 0.024). AZ scores were 0.7650, 0.7499, and 0.8008 respectively, for unenhanced Sidexis, enhanced Sidexis, and Ektaspeed Plus film. CONCLUSION Unenhanced digital Sidexis images were equivalent to film for the detection of proximal caries in this in vitro study. Observer enhanced Sidexis images exhibited a statistically significant lower diagnostic accuracy than the unenhanced digital and film images.

Periodontitis detection efficacy of film and digital images

OBJECTIVE The objective of this study was to evaluate the accuracy of alveolar crestal bone detection in a comparison of unenhanced and enhanced Sidexis (Siemens Medical Systems, Inc., Bensheim, Germany) digital images with Ektaspeed Plus (Eastman Kodak, Rochester, N.Y.) films by means of receiver operating characteristic analysis. STUDY DESIGN More than 100 proximal and furcal areas in the anterior and posterior areas of the mandible and maxilla of each of three tissue-equivalent human skull phantoms were imaged with film, direct digital images, and contrast- and brightness-enhanced digital images. Alveolar crest status was assessed by a consensus panel of three experts who used the Delphi method and evaluated information from all of the imaging modalities concurrently. Five observers assessed all images for the presence or absence of crestal bone loss using a five-point confidence scale. Receiver operating characteristic curves were generated, and calculated areas (Az) were analyzed by means of analysis of variance. RESULTS The expert panel determined that of 106 crestal areas, 48 were disease free and 58 exhibited bone loss greater than 2 mm apical to the cemento-enamel junction. Analysis of variance of observer Az scores showed significant differences among readers (p < 0.001) and among readings (p = 0.027), but not among modalities (p = 0.435). Mean Az values for the different modalities were as follows: Sidexis, 0.70; enhanced Sidexis, 0.71; Ektaspeed Plus films, 0.735. CONCLUSION The Sidexis digital imaging system was not significantly different from Ektaspeed Plus film for crestal bone evaluation in this in vitro study.

Densitometric comparisons of Ultra-speed, Ektaspeed, and Ektaspeed Plus intraoral films for two processing conditions

This study compared film speed, contrast, exposure latitude, and resolution of Ultra-speed, Ektaspeed, and Ektaspeed Plus films (Eastman Kodak Co., Rochester, N.Y.). Densitometric curves were generated for each film type under processing conditions of fresh and used chemistry to observe their effect on factors associated with diagnostic quality. Ektaspeed Plus film displayed the least variability due to processing condition of any film; it also demonstrated the fastest speed and was twice as fast as Ultra-speed film. Ektaspeed exhibited the greatest relative exposure latitude followed by Ektaspeed Plus and Ultra-speed. Average gradient over a clinically useful range of densities was greatest for Ultra-speed in fresh processing solutions, but greatest for Ektaspeed Plus in used processing solutions. All film types were able to resolve more than 16.6 line pairs per millimeter regardless of processing conditions. The results of this study suggest that dental practitioners who have refrained from using E-speed film because of the sensitivity of this film to variations in processing may now consider providing this dose-reducing technology for their patients with the expectation of obtaining consistent image quality.

Updated quality assurance self-assessment exercise in intraoral and panoramic radiography

This updated self-assessment exercise for the dental team by the Radiology Practice Committee of the American Academy of Oral and Maxillofacial Radiology is intended to produce the highest quality diagnostic radiographs while keeping patient exposure as low as is reasonably achievable. To continue to provide the best radiographic services to patients, those involved in dental radiography need to be aware of the latest changes and advances in dental radiography and need to use them in their practice.

A quantitative analysis of dental radiography quality assurance practices among North Carolina dentists

OBJECTIVE The purpose of this study was to assess the level of compliance with dental radiography quality assurance recommendations on the part of dental practitioners in the state of North Carolina and to determine whether the age of the practice was an influential factor affecting compliance. STUDY DESIGN On-site survey inspections by state officials using measurement devices and questionnaires were used to assess x-ray machine parameters and gather information about quality assurance practices in private offices in the state of North Carolina. RESULTS There were approximately three intraoral units per facility, with an average entrance skin exposure of 267 mR per bitewing radiograph. There were no significant differences associated with the age of the practice in quality assurance practices except with respect to the type of processor used: dentists who had been in practice for more than 20 years used manual processing more frequently than those who had been in practice for less than 20 years (p = 0.001). CONCLUSIONS Most practices showed a high level of compliance with equipment function requirements. North Carolina dentists are making an effort to comply with the American Academy of Oral and Maxillofacial Radiology recommendations. However, the use of faster film and rectangular collimation was much less than expected. Only 9% of the participants reported using E-speed film exclusively, and only 7.33% reported using rectangular collimation.

Skull base clear cell carcinoma, metastasis of renal primary tumor: a case report and literature review.

We report on a patient who presented with cranial nerve VI bilateral paresis, absence of pharyngeal reflex, dysarthria, right tongue deviation, and right facial paralysis. Imaging studies showed an expansive process in the cranial base with clivus and petrous apex osteolysis. A biopsy confirmed the presence of clear cell adenocarcinoma and suspicion of renal tumor metastases. Abdominal imaging studies revealed a mass in the right kidney. Consequently, radiotherapy was performed, and the patient was enrolled in a palliative care and pain control program.

Oncocytoma of the Parotid Gland: A Case Report and Review of the Literature

We report the case of a patient who presented to the ENT service with left facial swelling of 5 months duration. Imaging studies revealed a dense expansive mass confined to the inside of the left deep parotid lobule and moderate enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of an oncocytoma. The patient was treated with total parotidectomy, complete tumor resection and sparing facial nerve surgery. Today, the patient is disease free and has no complications.

Effects of focal spot size on caries diagnosis with D and E speed images

Annual measurement of the x-ray unit focal spot size has been recommended by the American Academy of Oral and Maxillofacial radiology as part of the dental radiographic quality control program. This study compares the effects of focal spot size on caries diagnosis. Three x-ray units with small, medium, and large focal spot sizes were used to produce bite-wing images on extracted teeth mounted in acrylic bases. Randomized films were scored for lesion presence and depth by two general dentists. Weighted kappa statistics were used to evaluate the agreement of reviewer caries diagnosis by film speed and focal spot size. Comparisons of caries cells with small versus medium and small versus large focal spot size produced weighted kappa statistics = 0.72 and 0.70, respectively. Differences in caries calls were greater because of film speed rather than focal spot size. The results of this study suggest that the clinical significance of varied focal spot size is negligible. The value of annual measurement of focal spot size is questionable, and its recommendation should be revisited.

Sinonasal Adenoid Cystic Carcinoma with Intracranial Invasion and Perineural Spread: A Case Report and Review of the Literature

We present the case of a 51-year-old patient with sinonasal adenoid cystic carcinoma (SACC). Computed tomography (CT) and magnetic resonance imaging (MRI) exams revealed an expansive process in the right nostril accompanied with perineural spread and invasion to the floor of the middle cranial fossa. Due to the size of the tumor and brain involvement, the Head and Neck Tumor Board (HNTB) recommended radiochemotherapy treatment to decrease the size of the lesion. Presently, the patient is undergoing treatment without major complications.

Use of Cone Beam Computed Tomography in the Diagnosis of Superior Semicircular Canal Dehiscence

Superior semicircular canal dehiscence is a relatively new syndrome in the field of otology. It is of unknown etiology presenting with a variety of vestibular and auditory symptoms and radiologic findings play a crucial role in its diagnosis. Cone beam computed tomography has been shown to be a powerful tool in the field of otolaryngology. It is a three dimensional technique that uses lower radiation resulting in fewer artifacts and offers higher resolution when compared with multi-slice computed tomography. It is considered to be an excellent imaging modality for radiological exploration of the ear.