Robert A. Cederberg

Endodontic working length assessment: Comparison of storage phosphor digital imaging and radiographic film

OBJECTIVE This study compared the difference in interpretation of the position of endodontic file tips between two imaging systems: photostimulable storage phosphor luminescence imaging versus radiographic film. STUDY DESIGN Thirteen patients were selected at random. Preoperative and trial file length radiographs were made with a dual image receptor composed of a Digora Digital Imaging Plate and a piece of Ektaspeed Plus film. Exposure techniques for E-speed film were used. Root length and file length measurements were made from digital images with the Digora systems measuring tools. Measurements were also made on radiographic film with a 7 x measuring magnifier. Root length, file length, and their difference were compared for both film and digital images. RESULTS Differences were found to be less in digital than in film images. Photostimulable storage phosphor luminescence imaging performed similarly to Ektaspeed Plus film for measuring root lengths, but file tip positions (especially of small file sizes) were difficult to visualize with E-speed film. CONCLUSIONS The smaller difference between file tip and root apex found with digital imaging suggests that this technique is more accurate to assess trial file length. This imaging modality for assessing file positions during root canal treatment may be beneficial to the practitioner.

Effect of the geometry of the intraoral position-indicating device on effective dose

OBJECTIVE The objective of this study was to calculate and compare the effective dose and to estimate risk from the use of intraoral position-indicating devices of differing geometries. STUDY DESIGN Thermoluminescent dosimeters were placed at selected sites in the upper portion of a tissue-equivalent human phantom to record the equivalent dose to weighted tissues and organs. The phantom was exposed to simulated complete mouth surveys with either a long (29.8 cm) or short (19.6 cm) round open-end position-indicating device, a long (35.3 cm) or short (23.3 cm) rectangular open-end position-indicating device, or a pointed (29.6 cm) closed-end position-indicating device. RESULTS The effective dose was calculated as the sum of the equivalent doses to each organ or tissue multiplied by that organ or tissues weighting factor. The salivary glands were included as part of the remainder. The effective dose ranged from 362 micro Sv for the pointed position-indicating device, to 63 micro Sv for both the long and the short rectangular position-indicating devices. CONCLUSIONS These effective doses were calculated to represent a probability for stochastic effects that range in magnitude from 26 x 10(-6) to 4.6 x 10(-6).

Temporomandibular joint space analysis.

Radiographic interpretation of the temporomandibular joint (TMJ) frequently revolves around a determination of condyle concentricity. The purpose of this study was to establish the relationship between actual and radiographic joint space, the latter determined from lateral corrected tomograms made by a Soredex Scanora. Vacuum-formed shims were placed over the condylar heads of a human skull and tomographic images of the TMJs were made. These shims were measured using a caliper and the mean thickness was used to represent actual joint space. Thickness of the shims fabricated for the right condyle varied from .15 mm (1 shim) to 1.60 mm (5 shims). The resulting radiographs were measured to determine the extent to which actual and radiographic joint space compared.

American Academy of Oral and Maxillofacial Radiology executive opinion statement on teleradiology

The American Academy of Oral and Maxillofacial Radiology (AAOMR) is the professional organization representing oral and maxillofacial radiologists in the United States. The AAOMR is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve the quality and access of radiologic services to the patient, and encourage continuing education for oral and maxillofacial radiologists, dentists, and persons practicing oral and maxillofacial imaging in allied professional fields. Teleradiology consists of (1) the transmission of radiographic images beyond the immediate vicinity of image acquisition, for the purpose of image interpretations by a receiving practitioner, and (2) the transmission of interpretations by the receiving practitioner to the requesting clinician. The AAOMR Executive Council (EC) endorses the use of teleradiology in dentistry as a supportive measure in excellent patient care. Teleradiology makes appropriate expertise available to referring clinicians in a timely manner. The following are examples of teleradiology applications in dentistry:

Electronic Health Records in Dentistry: Clinical Challenges and Ethical Issues

Today Electronic Health Records (EHRs) have enjoyed wide spread adoption as the optimal choice for the management of patient health information (PHI). EHRs provide several distinct advantages over the use of paper records or a combination of electronic and hard copy options. The ability to interconnect the convenience of computer and software functionality with large amounts of PHI which must be managed for all patients who are being treated by a myriad of health care professionals, including dentists, makes the marriage of electronic data management with the patient record a logical choice. However, the use of EHRs in hospitals, institutions, clinics and private practices also presents many clinical challenges, as well as the potential for a breach in ethical patient care. This chapter discusses the impact of bringing the computer into the patient treatment arena and its effect on the doctor patient relationship, the privacy and security of PHI, ethical issues and clinical challenges, the use of EHRs for research and development of cloud-based EHRs, as well as the future of this technology.

Multiple intraosseous cervical pneumatocysts: A case report of a rare incidental finding on cone-beam computed tomography

This report presents a case of cervical pneumatocysts as an incidental finding on cone-beam computed tomography. Pneumatocysts are gas-containing lesions of unknown etiology. They usually present in the ilium or sacrum, adjacent to the sacroiliac joint. In the literature, 21 case reports have described cervical pneumatocysts. Cervical pneumatocysts should be differentiated from other lesions, such as osteomyelitis, osteonecrosis, and neoplasms, as well as post-traumatic and post-surgical cases. Computed tomography, cone-beam computed tomography, and magnetic resonance imaging are appropriate tools to diagnose cervical pneumatocysts.