Comparison of the reproducibility of storage phosphor and film bitewings for assessment of alveolar bone loss

Hypodontia and retention of third molars in Norwegian medieval skeletons: dental radiography in osteoarchaeology

OBJECTIVES

The objective of the present study is to compare the prevalence of third molar hypodontia in matched medieval and modern Norwegian sample with the aim to examine whether there are secular changes in dental anomalies. A second objective is to determine the level of primary retention of third molar in the medieval sample.

MATERIAL AND METHODS

The medieval material consisted of 130 adult skulls, hypodontia of third molars was determined using radiography and compared to findings with panoramic film images of 400 15-year-old individuals from a contemporary Norwegian epidemiological study.

RESULTS

Among 130 medieval skulls, hypodontia of third molar was found in 36 skulls (27.7%), and in the contemporary sample, hypodontia of third molar was found in 69 individuals (17.2%). Female predominance, although not statistically significant, was observed both in the medieval and in the contemporary group. The third molars showed absence in the mandible (21.5%) more often than the maxilla in the medieval sample, and in both jaws (11.2%) in the contemporary material. In the medieval sample, only 7.7% of the individuals had at least one retained third molar.

CONCLUSION

No increase in the frequency of third molar hypodontia was found from the medieval period until today. The frequency of retained third molars seems to have increased from the medieval period to modern times. The use of radiographic examination in addition to macroscopic inspection can give us a better understanding of the aetiology on a number of conditions in human skeletal remains.

Assessment of periodontal bone level revisited: a controlled study on the diagnostic accuracy of clinical evaluation methods and intra-oral radiography

OBJECTIVES

The accuracy of analogue and especially digital intra-oral radiography in assessing interdental bone level needs further documentation. The aim of this study was to compare clinical and radiographic bone level assessment to intra-surgical bone level registration (1) and to identify the clinical variables rendering interdental bone level assessment inaccurate (2).

MATERIALS AND METHODS

The study sample included 49 interdental sites in 17 periodontitis patients. Evaluation methods included vertical relative probing attachment level (RAL-V), analogue and digital intra-oral radiography and bone sounding without and with flap elevation. The latter was considered the true bone level. Five examiners evaluated all radiographs.

RESULTS

Significant underestimation of the true bone level was observed for all evaluation methods pointing to 2.7 mm on average for analogue radiography, 2.5 mm for digital radiography, 1.8 mm for RAL-V and 0.6 mm for bone sounding without flap elevation (p < 0.001). Radiographic underestimation of the true bone level was higher in the (pre)molar region (p ≤ 0.047) and increased with defect depth (p < 0.001). Variation between clinicians was huge (range analogue radiography 2.2-3.2 mm; range digital radiography 2.1-3.0 mm).

CONCLUSION

All evaluation methods significantly underestimated the true bone level. Bone sounding was most accurate, whereas intra-oral radiographs were least accurate. Deep periodontal defects in the (pre)molar region were most underrated by intra-oral radiography.

CLINICAL RELEVANCE

Bone sounding had the highest accuracy in assessing interdental bone level.

Evaluation of simulated periodontal defects via various radiographic methods

OBJECTIVES

The aim of this study was to compare the diagnostic accuracy of conventional films and direct digital radiographs (DDR), in the determination of the depth and type of simulated periodontal intrabony defects.

MATERIALS AND METHODS

Three types of periodontal intrabony defects (one, two, and three walled) were artificially created in dry mandibles. Standard radiographic images were taken with Ultraspeed, Ektaspeed, Insight films, and DDR. The radiographic images were evaluated by three oral radiologists to identify the type and depth of these defects on the radiographs.

RESULTS

The average measured depth of the defects on the dry mandibles was 7.85 mm. The average depth of the type 1 defect on the radiographs was 7.19 mm, type 2 was 7.18 mm, and type 3 was 7.15 mm. The average depth of the defects via the Ultraspeed film was 7.15 mm, Ektaspeed film was 7.17 mm, Insight film was 7.19 mm, and DDR was 7.20 mm. Type 1, type 2, and type 3 defect depth measurements showed 8.9, 9.7, and 16.3% understated, respectively (p < 0.01). The accurate estimation rates of type 1, type 2, and type 3 defects were 93.8, 53, and 25.4%, respectively.

CONCLUSIONS

Both radiographic techniques have the same diagnostic value and display the minor destructive changes in the bone. As the number of osseous walls increases, it becomes difficult to determine the defect type and morphology. Further research is needed to monitor the intrabony defects, with less radiation exposure.

CLINICAL RELEVANCE

The accurate identification of defect type and depth depends on the number of walls, not the imaging methods.

The influence of tube potential on periodontal bone level measurements and subjective image quality using a digital photostimulable storage phosphor sensor

Objectives

The purpose of the present study was to determine the measurement accuracy and subjective image quality for periodontal disease diagnosis when using two X-ray tube voltages with a digital photostimulable storage phosphor sensor.

Material and Methods

A digital photostimulable storage phosphor (PSP) sensor (Vistascan) and a multipulse X-ray generator (Prostyle Intra) with two tube voltages were used in this study. The front, premolar and molar region of two adult human cadaver skulls jaws were imaged using the X-ray tube at 63 kV and 70 kV, both at 8 mA and decreasing exposure times (160 ms, 120 ms and 80 ms). A standardized exposure protocol containing waxed occlusal keys and an aiming device ensured proper and reproducible beam alignment. Three observers assessed the digital radiographs for 31 selected periodontal bone loss sites. Radiographic measurements were compared to physical measurements (Standard). Subjective ratings of lamina dura, crater defect and furcation involvement visibility, contrast perception and bone quality were also performed.

Results

Multiple regression equation of the variables kV and exposure time demonstrated no significant difference for the periodontal bone level measurements (P > 0.05). In 90.3% and 96.7% of the measurements for 70 kV and 63 kV respectively, deviation was within 1 mm. The subjective ratings produced similar findings in terms of image quality for both tube voltages and the three exposure times.

Conclusions

The results of the present study revealed that tube voltages of 63 kV and 70 kV provided similar accuracy and image quality for periodontal disease diagnosis.