The role of software in quality assurance for indirect digital intraoral imaging

Effect of 3 different disinfection methods on the image quality of photostimulable phosphor plates

OBJECTIVE

The aim of this study was to assess the effects of 3 disinfection protocols on the quality of images acquired with a photostimulable phosphor (PSP) plate system.

STUDY DESIGN

Thirty DIGORA Optime PSP plates were divided into 3 groups of 10. Group 1 was disinfected with 95% ethanol. Group 2 was disinfected using germicidal disposable wipes. Group 3 was disinfected with 95% ethanol, followed by hydrogen peroxide gas sterilization. Images of a quality assurance phantom were acquired on each plate before disinfection (baseline images). Disinfection and imaging cycles were repeated 45 times for each plate. Changes in image quality were assessed between baseline and final images. Image quality was evaluated for dynamic range, spatial resolution, and contrast perceptibility. The Fisher exact test was used to detect statistically significant differences among the 3 disinfection methods relative to decreases in image quality parameters between the baseline and final radiographs. Additionally, for each group, the Z-test was used to detect statistically significant decreases in image quality parameters between baseline and final images. The significance level was established at P < .05.

RESULTS

No statistically significant differences were detected among the disinfection groups or relative to baseline values for any group at a 5% significance level.

CONCLUSIONS

Hydrogen peroxide gas may be considered to prevent cross-contamination while preserving image quality. Regular quality assurance testing is recommended to maintain image quality over time.

The Limitations of Periapical X-ray Assessment in Endodontic Diagnosis-A Systematic Review

Diagnosis is a key aspect in endodontic treatment, in a decade where invasive interventions are misapprehended as social tendency instead of medical necessity. All diagnostic facets should be considered before intending the operative phase. Intraoral endodontic radiology-based diagnosis has been shown to be limited. Periapical X-ray is the most used endodontic imaging, yet it does not provide high accuracy. Traditionally, dentists have been trained to diagnose a cyst by certain aspects (size, shape and appearance); hence, an assumption that teeth are affected by "periapical cyst" were subjected to unnecessary extraction or apicoectomy. The aim of this systematic review is to critically appraise the publications that relate the histological diagnosis of a periapical lesion (considered the gold standard) to intraoral X-ray investigation. Ovid Medline, PubMed, ScienceDirect, Mendeley and Scopus were searched for English-language studies comparing periapical diagnosis obtained by using two techniques (histopathology and X-ray). Sixteen articles were included for the final analysis (qualitative and quantitative evaluation) out of which only two supported the statement that periapical diagnosis can be coherently assessed through periapical imaging. Although there is not enough evidence to deliver a definitive conclusion, there are many publications that refute the diagnosis of a cyst via periapical X-ray.

The Importance of the ANSI/ADA Standard for Digital Intraoral Radiographic Systems: A Pragmatic Approach to Quality Assurance

The need for quality assurance (QA) for digital dental radiography has existed since the introduction of digital imaging; however, the methods and phantoms required to achieve it were not available. This resulted in a chaotic approach to address QA based largely upon subjective analysis of image quality. The American National Standards Institute (ANSI)/American Dental Association (ADA) Quality Assurance Standard 1094 for Digital Intraoral Radiographic Systems (DIRS) presents a paradigm shift to a scientific and objective method of QA rather than one based on subjective assessments. This standard takes into account the contributions of all components of the digital imaging chain that affect final image quality rather than assessing the various components in isolation. The optimal image is determined for each DIRS through objective analysis of the image quality properties of dynamic range, spatial resolution, and contrast perceptibility. Image optimization, a critical component of a quality assurance program, is the proper balance between diagnostic image quality and radiation dose to the patient. This publication counters disseminated myths and misconceptions with scientific evidence and will help dental practitioners appreciate and understand the benefits of the new ANSI/ADA Standard on QA for DIRS.