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A survey of radiographic techniques and equipment used by a sample of general dental practitioners

A study of radiographic practices of general dentists was conducted by mail survey. Eighty percent of 963 dentists returned completed questionnaires. All participants resided in the province of Ontario, Canada, and were graduates of either of the two provincial dental schools. Fewer than one third of radiographs were taken by the dentist with only 10% of dentists taking three fourths or more of the radiographs in their practices. There was infrequent use of E speed film (11%) and rectangular collimation (8%). Automatic processing was used by 93% of dentists. Although the overwhelming majority of dentists used a film holder, 2% still have the patient hold the film. The type of film holder used was affected by dental school experience, whereas the use of E speed film was not.

Validation of dental radiographs for human identification.

Visual comparison of dental bitewing radiographs in simulated forensic identification, using observers of varying degrees of experience and radiographs with a range of time intervals from one to fifteen years showed an accuracy of 93%.

Long-Term Validation Study of Bitewing Dental Radiographs for Forensic Identification

The validity of dental bitewing radiographs for forensic identification, with time lapses between the antemortem and postmortem film of up to 30 years, was tested. The ability to match radiographs from the same subject was expressed using sensitivity and specificity statistics. Although the overall accuracy of the observers was extremely high, it was obvious that radiographs from the same individual, when separated by time intervals greater that 20 years, had significantly reduced accuracy.

A survey of the radiographic practices of general dentists for edentulous patients

OBJECTIVE The objective of the study was to evaluate the radiographic practice of general dentists for edentulous patients. STUDY DESIGN A questionnaire was sent to a sample of graduates from the two Ontario dental schools. RESULTS The adjusted response rate for the survey was 80%. Fifty-three percent of the respondents used screening radiography for new patients. The overwhelming choice for these dentists was the panoramic film. There was a significant positive association between ownership of a panoramic unit and use of this radiograph. Dentists who do not own a panoramic unit rarely chose to refer their patients for this radiograph either routinely or selectively. When dentists, rather than the auxiliaries, made the greater proportion of the radiographs, they tended to use selective radiography. Most dentists chose selective radiography for the recall patient. CONCLUSIONS Almost half the dentists did not follow the Food and Drug Administration/American Dental Association guideline of screening radiography for the new edentulous patient. Of those dentists who did follow the guideline the vast majority both owned panoramic units and chose to use a panoramic survey. Most dentists followed the guideline for selective radiography for the recall patient.

An investigation of potential applications of intensifying screens in intraoral radiography

In medicine, the somewhat degraded image from the screen/film system is accepted for most diagnostic purposes in the interest of radiation thrift. In dentistry, however, the superb image resolution and sharpness of the radiation-intensive, direct-exposure film is the standard for intraoral radiography. There may be occasions in dental practice where such quality is not necessary, thus making the high level of exposure difficult to justify. In a laboratory study, screen-type radiographs were effectively substituted for ultraspeed film in the monitoring stages of endodontic therapy and as posttreatment films in operative dentistry. Even with a slow system, the radiation exposure was one sixteenth of the usual periapical dose. If clinical trials support these conclusions, only the lack of a practical periapical cassette limits the application of this significant method of radiation reduction to dental practice.In medicine, the somewhat degraded image from the screen/film system is accepted for most diagnostic purposes in the interest of radiation thrift. In dentistry, however, the superb image resolution and sharpness of the radiation-intensive, direct-exposure film is the standard for intraoral radiography. There may be occasions in dental practice where such quality is not necessary, thus making the high level of exposure difficult to justify. In a laboratory study, screen-type radiographs were effectively substituted for ultraspeed film in the monitoring stages of endodontic therapy and as posttreatment films in operative dentistry. Even with a slow system, the radiation exposure was one sixteenth of the usual periapical dose. If clinical trials support these conclusions, only the lack of a practical periapical cassette limits the application of this significant method of radiation reduction to dental practice.

A clinical trial of a rare earth screen/film system in a periapical cassette☆

In a clinical trial, a slow rare earth screen/film system (Siemens Titan 2D/Kodak XG) was used to obtain intraoral radiographs at conventional monitoring stages in endodontic treatment. The screen film image proved to be an effective substitute for the direct-exposure Ultraspeed periapical film. The intraoral cassettes, designed and fabricated for the study, were an adaptation of the flexible, vacuum-sealed cassettes used in mammography. It is believed that when a practicable periapical cassette is manufactured, many additional indications for the system are probable. Major reductions in patient exposure of at least 85% to 90% per periapical film would be effected.

Hemifacial hypertrophy affecting the maxillary dentition

A case of hemihypertrophy affecting part of the right maxilla was followed for 8 years with sequential radiographs. The effects of this unusual condition on the developing dentition were documented. Advanced root formation prior to active resorption, increased deposition of secondary dentin, and the histopathologic description of a tooth have not been previously recorded.

THE VALIDITY OF BITEWING RADIOGRAPHS FOR THE DENTAL IDENTIFICATION OF CHILDREN

Visual comparison of antemortem and postmortem bitewing radiographs of children and adolescents were made by observers with a range of experience using an established protocol. There was no statistically significant difference between the sensitivity, specificity and accuracy of the test results between children (6–9 years) and adolescents (8–11 years). The average sensitivity, specificity and accuracy of the pooled results for children was marginally less than for adults, but the difference was not statistically significant.

An analysis of the scientific basis for the radiographic guideline for new edentulous patients

The FDA Radiology Guideline for the new edentulous patient recommends an initial survey of the arches. In the process of developing this recommendation, the expert panel reviewed the available literature and concluded that there was sufficient evidence to warrant screening radiography rather than selective radiography, which is the principle on which all the other recommendations are based. Our evaluation of the literature used by the panel for the edentulous recommendation identifies critical errors in the analysis of the data. Factors such as a vague definition of abnormality and a geographically diverse sample population might have led the expert panel to suggest a very conservative recommendation for this group of patients. The recommendation failed to consider the treatment impact of findings and was based simply on the large number of observations, regardless of their treatment or pathologic significance. However, in studies in which treatment is considered, it is clear that screening radiography for new edentulous patients does not yield sufficient clinically relevant information to support the guideline.

A study of the impact of screening or selective radiography on the treatment and postdelivery outcome for edentulous patients

OBJECTIVE The purpose of this study was to assess the impact of radiographic findings on complete denture treatment and on the postdelivery course of those patients who had pretreatment radiographs (the screening group) and those who did not (the selection group). METHOD In total, 375 cases were randomly selected by systematic sampling. Data collected included patient demographic information and denture history, predenture fabrication radiographic findings, and postdenture delivery complaints. RESULTS Of the screening patients, 100% had pretreatment radiographs made; this compared with 13.5% of the selection patients. In the screening group, 68.3% of patients had one or more positive radiographic findings recorded. Of the screening patients, 8.3% received treatment before denture fabrication; this compared with 1.2% of the selection patients. Of the 375 cases, 2 screening patients had postdelivery complaints that required management other than denture adjustment. CONCLUSION The results indicate that there is weak scientific support for the guideline recommending routine pretreatment radiography for new denture patients.