Quality of root fillings performed with two root filling techniques. An in vitro study using micro-CT

Objective.

The aim of this study was to compare the presence of voids in root fillings performed in oval and ribbon-shaped canals with two root filling techniques, lateral compaction technique (LCT) or hybrid technique (HT), a combination of a gutta-percha masterpoint and thermoplastic gutta-percha. Furthermore, the obturation time for the two techniques was evaluated.

Materials and methods.

Sixty-seven roots with oval and ribbon-shaped canals were prepared using Profile Ni-Ti rotary files. After preparation, the roots were randomly allocated to two groups according to root filling technique. All roots were filled with AH plus and gutta-percha. Group 1 was filled using LCT (n = 34) and group 2 was filled using HT (n = 33). The obturation time was measured in 30 cases evenly distributed between the two techniques. Voids in relation to the root canal fillings were assessed using cross-section images from Micro-computed Tomography scans.

Results.

All root canal fillings had voids. Permutation test showed no statistically significant difference between the two root filling techniques in relation to presence of voids (p = 0.092). A statistically significant difference in obturation time between the two techniques was found (p < 0.001).

Conclusion.

The present study found no statistically significant difference in percentage of voids between two root filling techniques. A 40% reduction in obturation time was found for the HT compared to the LCT.

Antimicrobial efficiency of ethanol and 2-propanol alcohols used on contaminated storage phosphor plates and impact on durability of the plate

OBJECTIVES

To assess (1) antimicrobial efficiency of wiping intraoral phosphor plates with alcohol tissues based on ethanol or 2-propanol alcohols after contamination with Candida albicans and Streptococcus oralis, (2) a concept for autodisinfection with ultraviolet light of the transport ramp in a scanner for phosphor plates and (3) the impact of wiping with alcohol tissues on durability of the plate.

METHODS

Suspensions of C. albicans and S. oralis were prepared in concentrations of 10(9) and 10(5) organisms per ml, and Digora (Digora(®) Optime Imaging Plate, size 2; Soredex, PalaDEx Group Brenntag Nordic A/S, Hellerup, Denmark) and Vista (VistaScan(®) Imaging Plate PLUS, size 2; Dürr Dental AG, Bietigheim-Bissingen, Germany) plates were contaminated. The plates were wiped with ethanol or 2-propanol disinfectant tissues and imprints obtained on agar. Number of microbial colonies after culturing was recorded. The scanner ramp was contaminated with C. albicans or S. oralis, respectively, the ultraviolet light (UV light) disinfection in the scanner was activated and the number of colonies after culturing was recorded. Plates from each system were sequentially wiped (5-60 times) with ethanol and 2-propanol, exposed and scanned. 48 images from each system were scored blind: 1 = no artefact, 2 = small artefacts and 3 = severe artefacts.

RESULTS

Ethanol eliminated C. albicans and S. oralis in high and low concentrations from both types of plates, whereas 2-propanol did not eliminate all micro-organisms at high concentrations. The UV light eliminated all micro-organisms from the ramp. Ethanol degraded the plates to a larger extent than did 2-propanol. Images from Vista plates showed severe artefacts after wiping with ethanol; those from Digora plates did not.

CONCLUSIONS

Ethanol eliminated all micro-organisms but degraded phosphor plates, whereas 2-propanol did not eliminate all micro-organisms and still degraded plates from Vista but not from Digora.

Influence of cone beam CT on treatment plan before surgical intervention of mandibular third molars and impact of radiographic factors on deciding on coronectomy vs surgical removal

OBJECTIVES

To assess the influence of cone beam CT (CBCT) on treatment plan before surgical intervention of mandibular third molars and to identify radiographic factors with an impact on deciding on coronectomy.

METHODS

186 mandibular third molars with an indication for surgical intervention underwent a radiographic examination with two methods: (1) panoramic imaging in combination with stereo-scanography and (2) CBCT. After the radiographic examination a treatment plan (TP) was established: either surgical removal (Sr) or coronectomy (Co). The first TP was based on the panoramic image and stereo-scanogram, while the second TP was established after CBCT was available. Logistic regression analyses were used to identify factors predisposing for Co after CBCT.

RESULTS

Treatment was performed according to the second TP. Agreement between the first and second TP was seen in 164 cases (88%), while the TP changed for 22 teeth (12%) after CBCT. Direct contact between the third molar and the mandibular canal had the highest impact on deciding on Co [odds ratio (OR) = 101.8, p < 0.001]. Direct contact was not a sufficient factor, however; thus, lumen narrowing of the canal (OR = 38.9-147.2, p < 0.001) and canal positioned in a bending or a groove in the root complex (OR = 32.8, p = 0.016) were additional canal-related factors for deciding on Co.

CONCLUSION

CBCT influenced the treatment plan for 12%. Direct contact in combination with narrowing of the canal lumen and canal positioned in a bending or a groove in the root complex observed in CBCT images were significant factors for deciding on coronectomy.

Validity of wax and acrylic as soft-tissue simulation materials used in in vitro radiographic studies

OBJECTIVE

To determine the thickness of wax and acrylic that provides a radiographic density similar to that of the human cheek.

METHODS

An intraoral film radiograph of the human cheek including a 40×30×3 mm reference aluminium block was recorded under standardized conditions in 61 subjects. Radiographic density was measured by a densitometer in ten randomly selected sites of the film to serve as the gold standard for density values of the cheek soft tissues. Thereafter, the density of series of radiographs of two tissue-simulating materials-wax and acrylic-in systematically increasing thicknesses (wax, 1.5-30 mm; acrylic, 2-40 mm) plus the reference block were measured and compared with the gold-standard values.

RESULTS

The radiographic density of wax with a thickness of 13-17 mm or acrylic with a thickness of 14.5 mm corresponded to the average density of the human cheek.

CONCLUSION

The soft tissues of the average human cheek can be simulated with 13-17 mm wax or 14.5 mm acrylic in in vitro radiographic studies.

Effect of varying displays and room illuminance on caries diagnostic accuracy in digital dental radiographs

In clinical practice, digital radiographs taken for caries diagnostics are viewed on varying types of displays and usually in relatively high ambient lighting (room illuminance) conditions. Our purpose was to assess the effect of room illuminance and varying display types on caries diagnostic accuracy in digital dental radiographs. Previous studies have shown that the diagnostic accuracy of caries detection is significantly better in reduced lighting conditions. Our hypothesis was that higher display luminance could compensate for this in higher ambient lighting conditions. Extracted human teeth with approximal surfaces clinically ranging from sound to demineralized were radiographed and evaluated by 3 observers who detected carious lesions on 3 different types of displays in 3 different room illuminance settings ranging from low illumination, i.e. what is recommended for diagnostic viewing, to higher illumination levels corresponding to those found in an average dental office. Sectioning and microscopy of the teeth validated the presence or absence of a carious lesion. Sensitivity, specificity and accuracy were calculated for each modality and observer. Differences were estimated by analyzing the binary data assuming the added effects of observer and modality in a generalized linear model. The observers obtained higher sensitivities in lower illuminance settings than in higher illuminance settings. However, this was related to a reduction in specificity, which meant that there was no significant difference in overall accuracy. Contrary to our hypothesis, there were no significant differences between the accuracy of different display types. Therefore, different displays and room illuminance levels did not affect the overall accuracy of radiographic caries detection.

Detection of cavitated approximal surfaces using cone beam CT and intraoral receptors

OBJECTIVES

The aim of this study was to compare cone beam CT (CBCT) in a small field of view (FOV) with a solid-state sensor and a photostimulable phosphor plate system for detection of cavitated approximal surfaces.

METHODS

257 non-filled approximal surfaces from human permanent premolars and molars were recorded by two intraoral digital receptors, a storage phosphor plate (Digora Optime, Soredex) and a solid-state CMOS sensor (Digora Toto, Soredex), and scanned in a cone beam CT unit (3D Accuitomo FPD80, Morita) with a FOV of 4 cm and a voxel size of 0.08 mm. Image sections were carried out in the axial and mesiodistal tooth planes. Six observers recorded surface cavitation in all images. Validation of the true absence or presence of surface cavitation was performed by inspecting the surfaces under strong light with the naked eye. Differences in sensitivity, specificity and agreement were estimated by analysing the binary data in a generalized linear model using an identity link function.

RESULTS

A significantly higher sensitivity was obtained by all observers with CBCT (p < 0.001), which was not compromised by a lower specificity. Therefore, a significantly higher overall agreement was obtained with CBCT (p < 0.001). There were no significant differences between the Digora Optime phosphor plate system and the Digora Toto CMOS sensor for any parameter.

CONCLUSIONS

CBCT was much more accurate in the detection of surface cavitation in approximal surfaces than intraoral receptors. The differences are interpreted as clinically significant. A CBCT examination performed for other reasons should also be assessed for approximal surface cavities in teeth without restorations.

Cone beam CT image artefacts related to head motion simulated by a robot skull: visual characteristics and impact on image quality

OBJECTIVES

The aim of this study was to assess artefacts and their impact on cone beam CT (CBCT) image quality (IQ) after head motion simulated by a robot skull.

METHODS

A fully dentate human skull incorporated into a robot simulated pre-determined patient movements. Ten head motion patterns were selected based on the movement of the C-arm of the CBCT units (no motion as reference). Three CBCT units were used [a three-dimensional eXam (K) (KaVo Dental GmbH, Biberach, Germany), a Promax 3D MAX (P) (Planmeca Oy, Helsinki, Finland) and a Scanora(®) 3D (S) (Soredex Oy, Tuusula, Finland)]. Axial images were qualitatively assessed at three levels: mental foramen (MF), infraorbital foramen and supraorbital foramen, and artefacts characterized as stripe-like, double contours, unsharpness or ring-like. A 100 mm visual analogue scale (VAS) was used to quantitatively assess IQ. Cross-sectional images of the lower third molar and MF bilaterally were also evaluated by VAS. Four blinded examiners assessed the images.

RESULTS

For all units and motion patterns, stripe-like artefacts were the most common. The four observers agreed on the presence of at least one artefact type in 90% of the images. Axial images showed lower overall IQ after motion (VAS = 72.4 ± 24.0 mm) than reference images (VAS = 97.3 ± 2.6 mm). The most severe artefacts were seen at the MF level. For cross-sectional images, IQ was lowest after tremor. The mean IQ range was 74-89 and 57-90 for isolated (tilting, rotation and nodding) and combined (nodding + tilting and rotation + tilting) movements, respectively. IQ for MF was lower than for third molar for any movement except tremor.

CONCLUSIONS

Head motion of any type resulted in artefacts in CBCT images. The impact on IQ depended on the region and level in the skull.

Patient discomfort in bitewing examination with film and four digital receptors

The aim was to compare patient discomfort during bitewing examination using five intra-oral receptors: a conventional film, a storage phosphor plate with a new soft cover, an already manufactured and sold sensor with a wire and two square and two rounded corners, a new version of a previously developed sensor with a wire and four square corners, and a newly developed sensor with a wire and four rounded corners. 60 patients participated in the study. The five receptors [a Kodak paper pack film (Eastman Kodak Company, Rochester, NY), a DIGORA® Optime phosphor plate (Soredex, Tuusula, Finland), and SuniRay (Suni Medical Imaging, Inc., San Jose, CA), DIGORA Toto (Soredex) and Snapshot (Instrumentarium Dental, Tuusula, Finland) complementary metal-oxide-semiconductors] with differences in ergonomic shape were placed in the mouth for a bitewing examination for approximately 10 s. The patients rated their discomfort on a 100 mm visual analogue scale after having had each receptor positioned. There was no significant difference in patient discomfort score between the conventional film and the Snapshot sensor (p > 0.05). Both conventional film and Snapshot were significantly less uncomfortable than the other receptors (p < 0.05). No significant difference was seen between the storage phosphor plate and the SuniRay sensor (p > 0.05). The storage phosphor plate was significantly less uncomfortable than the DIGORA Toto sensor (p < 0.05). There was no significant difference in the perception of discomfort between the conventional film and an ergonomically shaped wired sensor with rounded corners.

Thermography as a quantitative imaging method for assessing postoperative inflammation

OBJECTIVE

To assess differences in skin temperature between the operated and control side of the face after mandibular third molar surgery using thermography.

METHODS

127 patients had 1 mandibular third molar removed. Before the surgery, standardized thermograms were taken of both sides of the patient's face using a Flir ThermaCam™ E320 (Precisions Teknik AB, Halmstad, Sweden). The imaging procedure was repeated 2 days and 7 days after surgery. A region of interest including the third molar region was marked on each image. The mean temperature within each region of interest was calculated. The difference between sides and over time were assessed using paired t-tests.

RESULTS

No significant difference was found between the operated side and the control side either before or 7 days after surgery (p > 0.3). The temperature of the operated side (mean: 32.39 °C, range: 28.9-35.3 °C) was higher than that of the control side (mean: 32.06 °C, range: 28.5-35.0 °C) 2 days after surgery [0.33 °C, 95% confidence interval (CI): 0.22-0.44 °C, p < 0.001]. No significant difference was found between the pre-operative and the 7-day post-operative temperature (p > 0.1). After 2 days, the operated side was not significantly different from the temperature pre-operatively (p = 0.12), whereas the control side had a lower temperature (0.57 °C, 95% CI: 0.29-0.86 °C, p < 0.001).

CONCLUSIONS

Thermography seems useful for quantitative assessment of inflammation between the intervention side and the control side after surgical removal of mandibular third molars. However, thermography cannot be used to assess absolute temperature changes due to normal variations in skin temperature over time.

Thermographic imaging of facial skin--gender differences and temperature changes over time in healthy subjects

OBJECTIVES

To assess changes in facial skin temperature over time, to identify sources of variation related to skin temperature and to evaluate interobserver reproducibility in measurements of the thermograms.

METHODS

62 volunteers (32 females, 30 males, mean age 23.4, range 19.5-29.5 years) underwent thermography of the face (left and right side lateral images) on four occasions with approximately 2 months between each session. Three observers recorded the images and marked regions of interest (ROIs) in each image using dedicated software. Smoking, exercise habits and use of oral contraceptives were recorded.

RESULTS

A significant difference between sessions (≤1 °C, p<0.001) and between observers (≤0.11 °C, p<0.001) was identified. The difference between sides was not significant (≤0.07 °C, p=0.7). None of the interactions between side, session and observer were significant. Smoking, exercise habits and oral contraceptive intake were not significant impact factors when included as covariates in the analysis (p>0.1). ROI temperature was significantly higher in males than in females (0.7 °C, p<0.001). A mixed model analysis of variance showed that observer had little impact on the expected standard deviation, whereas session and subject had a greater impact.

CONCLUSIONS

Face temperature is symmetrical and varies over time. The non-significant difference between sides is highly reproducible, even between observers.

Evaluation of the RB-RB/LB-LB mnemonic rule for recording optimally projected intraoral images of dental implants: an in vitro study

OBJECTIVE

The aim of this study was to evaluate a simple mnemonic rule (the RB-RB/LB-LB rule) for recording intra-oral radiographs with optimal projection for the control of dental implants.

METHODS

30 third-year dental students received a short lesson in the RB-RB/LB-LB mnemonic rule. The rule is as follows: if right blur then raise beam (RB-RB), i.e. if implant threads are blurred at the right side of the implant, the X-ray beam direction must be raised towards the ceiling to obtain sharp threads on both implant sides; if left blur then lower beam (LB-LB), i.e. if implant threads are blurred at the left side of the implant, the X-ray beam direction must be lowered towards the floor to obtain sharp threads on both implant sides. Intra-oral radiographs of four screw-type implants placed with different inclination in a Frasaco upper or lower jaw dental model (Frasaco GmbH, Tettnang, Germany) were recorded. The students were unaware of the inclination of the implants and were instructed to re-expose each implant, implementing the mnemonic rule, until an image of the implant with acceptable quality (subjectively judged by the instructor) was obtained. Subsequently, each radiograph was blindly assessed with respect to sharpness of the implant threads and assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable and (4) hopeless.

RESULTS

For all implants, from one non-perfect exposure to the following, a higher score was obtained in 64% of the cases, 28% received the same score and 8% obtained a lower score. Only a small variation was observed among exposures of implants with different inclination. On average, two exposures per implant (range: one to eight exposures) were needed to obtain a clinically acceptable image.

CONCLUSION

The RB-RB/LB-LB mnemonic rule for recording intra-oral radiographs of dental implants with a correct projection was easy to implement by inexperienced examiners.

Incidence of caries lesions in approximal surfaces: a radiographic study of a general adult Danish population

The aim was to describe the incidence of caries lesions in a randomly selected adult population, and to identify risk factors related to the incidence of caries lesions in approximal surfaces. In 1997, 616 adults participated in a study including a radiographic survey. In 2003 these individuals were contacted again and offered a second radiographic survey; 473 consented and attended this examination. In approximal surfaces, presence/absence of caries lesions and presence and type of coronal fillings were recorded. The incidence of caries lesions in surfaces with no caries lesions in 1997 was studied. Potential risk factors included information at three levels: (1) person, (2) tooth, and (3) surface. The analysis was carried out by multilevel logistic regression. For the analyses 23,701 approximal surfaces were eligible. In 23,243 approximal surfaces no caries lesions were detected in 1997, 17,007 of these were surfaces without fillings, and 6,236 were filled surfaces. In unfilled surfaces several factors affected the risk for development of a caries lesion: young age, high number of fillings, number of teeth and status of the adjacent surface. In filled surfaces few factors affected the incidence of caries lesions: status of the adjacent surface, smoking and distal surfaces. Differences in risk factor patterns for the incidence of caries lesions were found for unfilled and filled surfaces. The study emphasizes the importance of assessing factors related to the incidence of caries lesions in adults. Further it underlines the need to analyse the fate of filled surfaces separately, because once a surface has received a filling it needs continuous attendance.

Accuracy of scanography using storage phosphor plate systems and film for assessment of mandibular third molars

OBJECTIVES

The aim of this study was to compare the diagnostic accuracy of two digital photostimulable storage phosphor (PSP) systems and film for assessment of mandibular third molars before surgery.

METHODS

110 patients were referred to have both their mandibular third molars removed. Each patient underwent a radiographic examination with scanography using either Digora (Soredex, Helsinki, Finland) and film or VistaScan (Dürr Dental, Beitigheim-Bissingen, Germany) and film in a randomized paired design. Two observers examined the following variables on the scanograms: bone coverage, angulation of the tooth in the bone, number of roots, root morphology and the relationship to the mandibular canal. In 75 of the pairs (Digora/film pair = 38 and Vista/film pair = 37) both third molars were eventually removed. During and after surgery the same variables were assessed, which served as reference standard for the radiographic assessments. The Wilcoxon signed-rank test tested differences in accuracy (radiographic compared with surgical findings) between Digora/film and between Vista/film.

RESULTS

There was no statistically significant difference between the diagnostic accuracy of film and either of the two digital receptors for assessment of mandibular third molars before surgery (P > 0.05), although Digora obtained a higher accuracy than film.

CONCLUSIONS

Scanography is a valuable method for examination of mandibular third molars before removal and the PSP digital receptors in this study were equal to film for this purpose.

[Diabetic maculopathy and retinopathy. Functional and sociomedical significance]

OBJECTIVE

The incidence of diabetic microvascular complications is expected to increase by 20-50% in the coming years. Diabetic macular edema (DME) is already a leading cause of blindness in the working-age population in developed countries, and its impact is expected to increase dramatically.

METHODS

Recent literature on the epidemiology and impact of diabetic microangiopathy (maculopathy) on visual function was reviewed to provide a comprehensive overview of the functional and socioeconomic consequences of diabetic retinal microangiopathy and new therapeutic strategies.

RESULTS

The first changes indicating diabetic microangiopathy are detectable shortly after the development of hyperglycemia, and in the long term they induce severe organ damage. More resources are used for this condition's treatment than for the treatment of hyperglycemia, corresponding to an enormous sociomedical burden of disease. Early detection of increased retinal vascular permeability may help control treatment effects. The control of recognized risk factors for the development and progression of DME, namely hyperglycemia and hyperlipidemia, as well as of hypertension has remained the cornerstone of therapy and serves as the basis for preserving visual function.

CONCLUSIONS

Modern treatment options, begun early, may result in a remarkably delayed occurrence of irreversible diabetic microvascular pathologies, particularly diabetic retinopathy and maculopathy. Ophthalmological screening nowadays aims at earlier recognition of at-risk individuals to optimize the therapeutic strategy--that is, before visual impairment is imminent. Close interdisciplinary medical cooperation and implementation of new therapeutic options may provide the foundation for success in terms of maintaining visual function.

Matching simulated antemortem and post-mortem dental radiographs from human skulls by dental students and experts: testing skills for pattern recognition

The aim of this study was to evaluate the ability of undergraduate dental students to match simulated ante- and post-mortem radiographs in human skulls with experts as controls for the 1)number of post-mortem images needed for a match, 2)accuracy of the matches, and 3)time spent for a match. A film bitewing was recorded in each side of 51 dentate dry human skulls (a.m.-images) and digital images of the teeth were recorded using a sensor (p.m.-images). 102 correctly matching and 102 non-matching image pairs were constructed. Ten students and three experts scored the image pairs as: certain match, certain non-match, or uncertain. None of the experts but half of the students made false positive scores. Half of the students performed just as accurately as the experts. All students (except one who made 8 FPs) asked for more p.m.-images than did the experts before deciding on a match, however, all students, but one, also spent less time per image pair than did the experts before deciding on a match (P<0.001). This simulated test sample may identify dental students and dentists with abilities for pattern recognition and thus help in the decision on who might be included as part of a forensic dental team when extra help is needed.

Effect of monitor display on detection of approximal caries lesions in digital radiographs

OBJECTIVES

The aim was to compare the accuracy of five flat panel monitors for detection of approximal caries lesions.

METHODS

Five flat panel monitors, Mermaid Ventura (15 inch, colour flat panel, 1024 x 768, 32 bit, analogue), Olórin VistaLine (19 inch, colour, 1280 x 1024, 32 bit, digital), Samsung SyncMaster 203B (20 inch, colour, 1024 x 768, 32 bit, analogue), Totoku ME251i (21 inch, greyscale, 1400 x 1024, 32 bit, digital) and Eizo FlexScan MX190 (19 inch, colour, 1280 x 1024, 32 bit, digital), were assessed. 160 approximal surfaces of human teeth were examined with a storage phosphor plate system (Digora FMX, Soredex) and assessed by seven observers for the presence of caries lesions. Microscopy of the teeth served as validation for the presence/absence of a lesion.

RESULTS

The sensitivities varied between observers (range 7-25%) but the variation between the monitors was not large. The Samsung monitor obtained a significantly higher sensitivity than the Mermaid and Olórin monitors (P<0.02) and a lower specificity than the Eizo and Totoku monitors (P<0.05). There were no significant differences between any other monitors. The percentage of correct scores was highest for the Eizo monitor and significantly higher than for the Mermaid and Olórin monitors (P<0.03).

CONCLUSIONS

There was no clear relationship between the diagnostic accuracy and the resolution or price of the monitor. The Eizo monitor was associated with the overall highest percentage of correct scores. The standard analogue flat panel monitor, Samsung, had higher sensitivity and lower specificity than some of the other monitors, but did not differ in overall accuracy for detection of carious lesions.

Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection

OBJECTIVES

Our aim was to compare periapical radiography and cone beam CT (CBCT) for assessment of the periapical bone defect 1 week and 12 months after root-end resection.

METHODS

50 patients (58 teeth) with a persisting apical periodontitis in a root-filled tooth (incisor, canine or premolar) were treated with root-end resection. 1 week and 12 months post-operatively, a CBCT scan (NewTom 3G) and a periapical radiograph (Digora) were obtained. Three observers detected and measured the periapical bone defects on periapical radiographs and CBCT images (coronal and sagittal sections).

RESULTS

1 week post-operatively, a periapical bone defect area was measured in all teeth by all observers. The defect was 10% smaller on periapical radiographs (mean = 12.4 mm2, SD = 8.2) than on the CBCT images measured in the coronal plane (mean = 13.0 mm2, SD = 7.8), a difference which was not statistically significant (P = 0.58). 12 months post-operatively (n = 52), there was considerable variation between the observers' detection of a remaining defect on the periapical radiographs and the CBCT images. The average agreement between the periapical radiograph and the CBCT images in the coronal sections was 67%, and more defects were detected on CBCT than on periapical radiographs.

CONCLUSIONS

On average, the periapical bone defect measured on periapical radiographs was approximately 10% smaller than on coronally sectioned CBCT images 1 week post-operatively. More remaining defects were detected 1 year after periapical surgery on CBCT images than on periapical radiographs, but it is uncertain how this information is related to success or failure after root-end resection.

Effect of explaining radiographic information to the patient before third molar surgery

OBJECTIVES

The aim of this study was to compare patient satisfaction with the pre-operative information before and after explaining the radiograph and to compare patient satisfaction with the radiographic information when based on a digital or a conventional image, as well as on extraoral or intraoral images.

METHODS

263 patients (with 301 mandibular third molars) were given pre-operative information by one of two trained scholar students before removal of the third molar. The course of the surgery and possible post-operative complications and risks were explained to the patient. The patients rated their satisfaction with the information on a 100 mm visual analogue scale (VAS). The radiograph was displayed and the radiographic information was explained to the patient, with emphasis on tooth-specific risk factors. The patients again rated their satisfaction on a VAS.

RESULTS

There was no significant difference in patient satisfaction score before (mean VAS = 92.5 mm) and after (mean VAS = 91.7 mm) the radiographic information was explained (P = 0.15). No difference in satisfaction was found between patients who were shown either digital or conventional images or between patients who were shown either extraoral or intraoral images (P > 0.5).

CONCLUSIONS

No additional patient satisfaction was obtained by showing and explaining the radiograph to the patient before lower third molar surgery. If the dentist still wishes to show the patient the radiograph, the type of image seems not to be important.