Panoramic radiography and patients with disability: a new simple breathing technique to reduce common airspace error

Effect of using different strips on reducing the most common error in panoramic imaging: A randomised controlled trial on palatoglossal air space shadow

INTRODUCTION

Panoramic radiography quality can be impaired by some errors such as positioning errors. Palatoglossal air space shadow error is one of the most common positioning errors and it is due to the tongue not sticking to the roof of the palate. Techniques used to deal with this error might help prevent unnecessary radiation to patients and save them time and money. The study aimed to investigate the effects of using celluloid matrix and edible tapes (fruit leather and chewing gum) on reducing the palatoglossal air space shadow error in panoramic imaging.

METHODS

In our study, 270 patients referred to the Department of Radiology were randomised into three groups: a control group, a celluloid matrix group and an edible tapes group. Before panoramic imaging, all patients were instructed to adhere their tongues to the roof of their mouths, with the distinction that for the celluloid matrix and edible tapes groups, patients were asked to place celluloid tapes, fruit leathers, or chewing gums on their tongues before doing so. The routine imaging process was then performed, and the results were compared across groups to evaluate the incidence of palatoglossal air space shadow error.

RESULTS

The number of error-free images in each fruit leather, chewing gum and celluloid tape group were significantly higher than the control group (all cases P < 0.05). The chances of error-free images in the fruit leather groups were the highest (9.57 times). The age (P = 0.136) and gender (P = 0.272) of patients had no significant effect on the results of interventions.

CONCLUSION

The application of fruit leathers, chewing gums and celluloid tapes reduced the palatoglossal air space shadow error of panoramic imaging.

Determination of relative dose of ionizing radiation in the thyroid gland using a panoramic device with different protocols

BACKGROUND

The use of panoramic radiography (PR) is a complementary examination to aid in the diagnosis of cases in paediatric dentistry. The lack of specific protocols for these devices, however, can result in high doses of radiation, affecting critical organs such as the thyroid.

AIM

To evaluate the discrepancies in ionizing radiation received by the thyroid during PR examinations using anthropomorphic paediatric simulators built from computed tomography images.

DESIGN

Two anthropomorphic paediatric phantoms were printed and used, representing children aged 6 and 11 years, with an opening in the thyroid region for the insertion of dosimetric radiographic films. The simulators were subjected to different pre-existing protocols in the PR devices. The radiographic films were processed and analysed using a luxmeter.

RESULTS

The radiation dose to the thyroid was higher in the 6-year-old phantom than in the 11-year-old phantom, for given exposure factors. In addition, there was an increase in dose in children's protocols compared with small adult protocols.

CONCLUSION

Therefore, companies that develop PR equipment must develop child protocols for separate age groups that will consequently reduce the radiation dose in children, especially in their critical organs.

Panoramic radiographs and dental patients with Down syndrome: A scoping review

INTRODUCTION

Life expectancy for people with Down syndrome (DS) has increased to 60 years, although poor oral health affects their quality of life. Panoramic radiographs (PRs) are usually well-tolerated by people with DS and can provide valuable diagnostic data for treatment planning and research. Methods A scoping review of peer-reviewed articles published between 1971and 2021 was conducted in accordance with the PRISMA extension for scoping reviews to determine the scope of use of PRs for people with DS.

RESULTS

937 papers were screened, and 52 papers were included and charted into seven categories in this review. A high prevalence of tooth agenesis (TA) and other anomalies were reported in 45% of papers. Severe periodontal disease was considered characteristic of DS in the 1970s-80s and the benefit of time-consuming treatment was questioned. Since 2000 case reports illustrate that improved oral care, orthodontic treatment, and dental implants under local or general anaesthetic can improve the quality of life for people with DS.

CONCLUSION

PRs play an important role in the diagnosis of anomalies, periodontal disease, and implant planning for patients with DS. This review highlights the gaps in research of caries, pathology, TMJ, systemic disease indicators, and guidelines for dentists. Systematic PR viewing, with a knowledge of characteristic features of DS, will assist diagnosis of pathology and improve comprehensive dental care treatment planning for children and adults with DS.

Fusion extracted features from deep learning for identification of multiple positioning errors in dental panoramic imaging

BACKGROUND

Dental panoramic imaging plays a pivotal role in dentistry for diagnosis and treatment planning. However, correctly positioning patients can be challenging for technicians due to the complexity of the imaging equipment and variations in patient anatomy, leading to positioning errors. These errors can compromise image quality and potentially result in misdiagnoses.

OBJECTIVE

This research aims to develop and validate a deep learning model capable of accurately and efficiently identifying multiple positioning errors in dental panoramic imaging.

METHODS AND MATERIALS

This retrospective study used 552 panoramic images selected from a hospital Picture Archiving and Communication System (PACS). We defined six types of errors (E1-E6) namely, (1) slumped position, (2) chin tipped low, (3) open lip, (4) head turned to one side, (5) head tilted to one side, and (6) tongue against the palate. First, six Convolutional Neural Network (CNN) models were employed to extract image features, which were then fused using transfer learning. Next, a Support Vector Machine (SVM) was applied to create a classifier for multiple positioning errors, using the fused image features. Finally, the classifier performance was evaluated using 3 indices of precision, recall rate, and accuracy.

RESULTS

Experimental results show that the fusion of image features with six binary SVM classifiers yielded high accuracy, recall rates, and precision. Specifically, the classifier achieved an accuracy of 0.832 for identifying multiple positioning errors.

CONCLUSIONS

This study demonstrates that six SVM classifiers effectively identify multiple positioning errors in dental panoramic imaging. The fusion of extracted image features and the employment of SVM classifiers improve diagnostic precision, suggesting potential enhancements in dental imaging efficiency and diagnostic accuracy. Future research should consider larger datasets and explore real-time clinical application.

Post-Traumatic-Related Technical Errors in Orthopantomographic Imaging

Background: This study aimed at identifying errors encountered in orthopantomography (OPG) in post-traumatic patients caused by limitations in performing a correct technique. Methods: A retrospective observational study was performed. Diagnosis, exposure/processing mistakes, positioning-related errors, and bimaxillary immobilization were evaluated. Results: Thirty panoramic radiographs with mandible fractures were examined. Twelve error types were encountered: errors in exposure or processing, air radiolucency in the palatoglossal space, errors in the alignment of the Frankfort horizontal plane: head in flexion, with a joyful expression or head extended, with a somber appearance, errors towards the mid-sagittal plane (lateral head inclination, deviation, or rotation), errors caused by the non-use of the bite-block or inappropriate position on the device, errors caused by positioning outside the focal plane, artifacts/shadow images produced by post-operative metal plates, and bimaxillary immobilization errors. The number of errors per radiograph ranged from two to a maximum of five. The most dominant ones were inappropriate alignment in the focal plane and lateral rotation of the head in over 70% of cases. Lateral deviation and palatoglossal air were present in more than 50% of images. Conclusions: In trauma cases, technical difficulties in obtaining a proper OPG image are common and often insurmountable, limiting the diagnosis.