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Natto ZS, Olwi A, Abduljawad F. A comparison of the horizontal and vertical bitewing images in detecting approximal caries and interdental bone loss in posterior teeth: A diagnostic accuracy randomized cross over clinical trial. J Dent Sci 2022; 18:645-651. [PMID: 37021254 PMCID: PMC10068384 DOI: 10.1016/j.jds.2022.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/06/2022] [Indexed: 10/15/2022] Open
Abstract
Background/purpose Horizontal bitewing radiographs are widely and frequently used in dentistry and are very reliable in diagnosing proximal caries and interproximal alveolar bone level. However, it is challengeable in detecting interproximal root caries, horizontal and/or vertical alveolar bone loss, and furcation involvements. The aim of this article was to assess the accuracy of vertical bitewing images in the diagnosis of caries and alveolar bone level compared to the horizontal bitewing technique. Materials and methods Each one of the 20 patients had eight bitewing radiographs to get four horizontal bitewing (control) and four vertical bitewing (experimental) images for the same posterior area; a steel wire (3 mm) was used on the sensor plate to help measure the magnification later on. The radiographs were processed digitally and were evaluated for caries by two expert restorative specialists and for bone loss by two experienced periodontists. They were also compared to the "gold standard," which is using of both clinical and radiographic examination for diagnosis. They were blinded to each other during images evaluation. Results Of the 20-patient sample size, 70% were male and 30% were female, with a mean age of 29.9. The average number of radiographs taken to achieve four standard bitewing radiographs was 5.9 ± 1.7 for vertical bitewings and 5.3 ± 1.3 for horizontal bitewing radiograph. The measurements from the cementoenamel junction (CEJ) to the level of crestal bone didn't show a significant difference between the horizontal and vertical bitewing radiographs. The detection of furcation area in the molar teeth was much higher in the vertical bitewing (100%) compared to the horizontal bitewing (57.5%) (P < 0.0001). Conclusion: The vertical bitewing radiograph has the upper hand over the horizontal bitewing radiograph in the detection of furcation involvement, caries detection, and alveolar bone loss. Therefore, it is highly recommended to use vertical bitewing in caries and patients with periodontal disease rather than the conventional horizontal bitewing.
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Assessment of periodontal bone level revisited: a controlled study on the diagnostic accuracy of clinical evaluation methods and intra-oral radiography. Clin Oral Investig 2017; 22:425-431. [PMID: 28550521 DOI: 10.1007/s00784-017-2129-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/15/2017] [Indexed: 02/06/2023]
Abstract
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.
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Mehdizadeh M, Maarefat N, Bagherieh S. Comparison of Accuracy of determining the Distance between Alveolar Crest and Cementoenamel Junction in Digital Radiography with Scanora and DentalEye Software Programs. J Contemp Dent Pract 2016; 17:815-819. [PMID: 27794151 DOI: 10.5005/jp-journals-10024-1936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To compare the accuracy of determining the distance between alveolar crest and cementoenamel junction (CEJ) in digital radiography with two image processing software programs. MATERIALS AND METHODS In this in vitro study, 63 sites in a dried human mandible underwent digital periapical radiography. The distance from the alveolar crest to the CEJ was calculated using DentalEye and Scanora software programs and compared with the standard mode (measured on the skull). Statistical analysis was performed with analysis of variance (ANOVA) and paired t-test using Statistical Package for the Social Sciences (SPSS) 23 at α = 0.05. RESULTS There were significant differences in the distances between CEJ and the alveolar crest at the mesial surfaces as measured by the three techniques in standard mode, using DentalEye and Scanora (p-value ≤ 0.03) softwares; however, there were no significant differences between the results on distal surfaces (p-value = 0.248). CONCLUSION Under the limitations of the present study, the measurements made to determine the distance from the CEJ to the alveolar crest with DentalEye and Scanora, relative to each other, and relative to the standard mode, were accurate only on distal surfaces of teeth. CLINICAL SIGNIFICANCE Digital dental software programs are useful assets that can enhance the diagnosing ability and reduce the need of taking extra images.
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Affiliation(s)
- Mojdeh Mehdizadeh
- Department of Radiology, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran
| | - Negar Maarefat
- Student Research Committee, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran
| | - Shervin Bagherieh
- Student Research Committee, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran, Phone: +00989132881338, e-mail:
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Ashwinirani S, Suragimath G, Jaishankar H, Kulkarni P, Bijjaragi SC, Sangle VA. Comparison of diagnostic accuracy of conventional intraoral periapical and direct digital radiographs in detecting interdental bone loss. J Clin Diagn Res 2015; 9:ZC35-8. [PMID: 25859522 PMCID: PMC4378804 DOI: 10.7860/jcdr/2015/12259.5562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms, resulting in destruction of the periodontal ligament and alveolar bone. Progressive loss of alveolar bone is the salient feature of periodontal disease. Accurate detection of periodontal disease with the use of radiographs helps in diagnosis, treatment and prognosis. AIMS The present study aims to compare the efficacy of conventional intraoral periapical (IOPA) and direct digital radiographs (RVG) in detecting interdental alveolar bone loss using intrasurgical (IS) measurements as the gold standard. MATERIALS AND METHODS Thirty patients elected to undergo periodontal flap surgery with periodontitis computing to 60 interdental alveolar defects on mandibular first molars were considered. IOPA and RVG were captured using standardized techniques. Bone loss measurements in IOPA and RVG were compared to the IS measurements. STATISTICAL ANALYSIS Statistical analysis was carried out using student t test and ANOVA with the help of SPSS software and p-value <0.05 was considered as significant. RESULTS Both IOPA and RVG underestimated the bone loss measurements when compared to IS measurements which was statistically significant (p<0.0001). Bone loss measurements in RVG were closer to IS measurements than IOPA. CONCLUSION Both the radiographic techniques IOPA and RVG underestimated bone loss by 1.5-2.5 mm. RVG was superior to IOPA for the detection of interdental bone loss due to reduced time and radiation exposure to obtain the same diagnostic information.
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Affiliation(s)
- S.R. Ashwinirani
- Senior Lecturer, Department of Oral Medicine and Radiology, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India
| | - Girish Suragimath
- Professor and HOD, Department of Periodontology, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India
| | - H.P. Jaishankar
- Professor, Department of Oral Medicine & Radiology, JSS Dental College & Hospital, Mysore, Karnataka, India
| | - Prasad Kulkarni
- Professor and HOD, Department of Periodontology, Kalinga Institute of Dental Sciences, KIMS Campus, Bubaneshwar, Odisha, India
| | - Shobha C. Bijjaragi
- Senior Lecturer, Department of Oral Medicine and Radiology, MIDSR Dental College, Ambajogai road, kasargaon, Latur, Maharashtra, India
| | - Varsha Ajit Sangle
- Senior lecturer, Department of Oral Pathology, MIDSR Dental College, Latur, Maharashtra, India
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Takeshita WM, Vessoni Iwaki LC, Da Silva MC, Tonin RH. Evaluation of diagnostic accuracy of conventional and digital periapical radiography, panoramic radiography, and cone-beam computed tomography in the assessment of alveolar bone loss. Contemp Clin Dent 2014; 5:318-23. [PMID: 25191066 PMCID: PMC4147806 DOI: 10.4103/0976-237x.137930] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: To evaluate the diagnostic accuracy of different radiographic methods in the assessment of proximal alveolar bone loss (ABL). Materials and Methods: ABL, the distance between cement-enamel junction and alveolar bone crest, was measured in 70 mandibular human teeth – directly on the mandibles (control), using conventional periapical radiography with film holders (Rinn XCP and Han-Shin), digital periapical radiography with complementary metal-oxide semiconductor sensor, conventional panoramic, and cone-beam computed tomography (CBCT). Three programs were used to measure ABL on the images: Image tool 3.0 (University of Texas Health Sciences Center, San Antonio, Texas, USA), Kodak Imaging 6.1 (Kodak Dental Imaging 6.1, Carestream Health®, Rochester, NY, USA), and i-CAT vision 1.6.20. Statistical analysis used ANOVA and Tukey's test at 5% significance level. Results: The tomographic images showed the highest means, whereas the lowest were found for periapical with Han-Shin. Controls differed from periapical with Han-Shin (P < 0.0001). CBCT differed from panoramic (P = 0.0130), periapical with Rinn XCP (P = 0.0066), periapical with Han-Shin (P < 0.0001), and digital periapical (P = 0.0027). Conventional periapicals with film holders differed from each other (P = 0.0007). Digital periapical differed from conventional periapical with Han-Shin (P = 0.0004). Conclusions: Conventional periapical with Han-Shin film holder was the only method that differed from the controls. CBCT had the closest means to the controls.
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Comparison between embossed digital imaging and unprocessed film-based radiography in detecting periodontal bone defects: an in vitro study. Oral Radiol 2012. [DOI: 10.1007/s11282-012-0088-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tihanyi D, Gera I, Eickholz P. Influence of individual brightness and contrast adjustment on accuracy of radiographic measurements of infrabony defects. Dentomaxillofac Radiol 2011; 40:177-83. [PMID: 21346085 PMCID: PMC3611457 DOI: 10.1259/dmfr/56018062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 02/19/2010] [Accepted: 02/19/2010] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess the accuracy of radiographic measurements of infrabony defects and to compare the accuracy with and without individual digital adjustment of brightness and contrast. METHODS In 41 periodontitis patients (19 females, 22 males; age range 23-73 years), 50 radiographs of 50 infrabony defects were obtained. All radiographs were digitized. Using a personal computer program, the linear distances between cemento-enamel junction (CEJ) and alveolar crest (AC) and between CEJ and bony defect (BD), and the depth of the infrabony defect (INFRA), were measured twice, according to the individual judgement of the radiographic examiner: (1) without digital adjustment (W) and (2) after use of contrast and brightness adjustment (A). Intrasurgical bone measurements served as the gold standard. The accuracy of measurements with or without digital adjustment was compared. RESULTS Radiographic measurements underestimated the gold standard for CEJ-BD (W: 1.1 mm ± 1.8 mm, P < 0.001; A: 1.0 mm ± 1.9 mm, P = 0.001). Both CEJ-AC (W: 0.2 mm ± 2.5 mm; A: 0.5 mm ± 2.6 mm) and INFRA (W: -0.4 mm ± 2.4 mm; A: -0.6 mm ± 2.5 mm) measurements came close to the gold standard. Statistically significant differences between W and A regarding accuracy were not observed. CONCLUSIONS The measurement tool used in this study provided high-accuracy measurements of periodontal bone loss in INFRA. Individual brightness and contrast adjustment failed to improve accuracy.
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Affiliation(s)
- D Tihanyi
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - I Gera
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - P Eickholz
- Department of Periodontology, Centre for Dental, Oral and Maxillofacial Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
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Adyani-Fard D, Kim TS, Eickholz P. Interproximal bone loss at contra-lateral teeth with and without root canal filling in periodontitis patients. J Clin Periodontol 2010; 38:269-75. [DOI: 10.1111/j.1600-051x.2010.01657.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kamburoğlu K, Gülşahı A, Genç Y, Paksoy CS. A comparison of peripheral marginal bone loss at dental implants measured with conventional intraoral film and digitized radiographs. J ORAL IMPLANTOL 2010; 38:211-9. [PMID: 20712442 DOI: 10.1563/aaid-joi-d-09-00147] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of the present study was to examine the effects of conventional and bone-condensing implantation techniques and time (6 and 12 months after implantation) on levels of marginal bone surrounding implants and to assess the level of agreement between measurements made using digitized intraoral images and film. The study group consisted of 14 healthy patients (9 female, 5 male; age range, 23-59 years; mean age, 41.1 years) with 28 single-tooth dental implants. In each patient, an implant was placed on one side using a conventional technique and on the opposite side using a bone-condensing technique. Film radiographs were taken at 6 and 12 months following implant placement and were digitized at 300 dpi and 600 dpi using a laser scanner. All scanned images were stored as both TIFF and JPEG files. A single observer twice measured distal and mesial marginal bone loss from film and digitized images. At the mesial site, there was a significant main effect of time (6 and 12 months after implantation) on the measurement of bone loss, F(1, 26) = 6.08, P = .02, but no significant main effect of implantation technique, F(1, 26) = 1.56, P = .223, and no significant interaction between time and technique, F(1, 26) = 2.09, P = .160. Similarly, at the distal site, there was a significant main effect of time on the measurement of bone loss, F(1, 26) = 14.1, P = .001, but no significant main effect of implantation technique, F(1, 26) = 1.21, P = .281. However, in contrast to the mesial site, there was also significant interaction between technique and time on the distal site, F(1, 26) = 4.974, P = .035. Intraobserver intraclass correlation coefficients and repeatability measurements showed high agreement for all image types. The bone-condensing technique resulted in greater marginal bone loss. Marginal bone measurements made using digitized intraoral images and conventional film showed high levels of agreement.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Ankara University, Department of Dentomaxillofacial and Radiology, Ankara, Turkey.
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Vandenberghe B, Bosmans H, Yang J, Jacobs R. A comprehensive in vitro study of image accuracy and quality for periodontal diagnosis. Part 2: The influence of intra-oral image receptor on periodontal measurements. Clin Oral Investig 2010; 15:551-62. [DOI: 10.1007/s00784-010-0417-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 04/14/2010] [Indexed: 11/30/2022]
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Vandenberghe B, Corpas L, Bosmans H, Yang J, Jacobs R. A comprehensive in vitro study of image accuracy and quality for periodontal diagnosis. PART 1: The influence of X-ray generator on periodontal measurements using conventional and digital receptors. Clin Oral Investig 2010; 15:537-49. [DOI: 10.1007/s00784-010-0416-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 04/14/2010] [Indexed: 12/01/2022]
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Vandenberghe B, Jacobs R. The influence of tube potential on periodontal bone level measurements and subjective image quality using a digital photostimulable storage phosphor sensor. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2010; 1:e5. [PMID: 24421961 PMCID: PMC3886041 DOI: 10.5037/jomr.2010.1105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 12/18/2009] [Indexed: 01/05/2023]
Abstract
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.
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Affiliation(s)
- Bart Vandenberghe
- Oral Imaging Center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
| | - Reinhilde Jacobs
- Oral Imaging Center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
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Corbet EF, Ho DKL, Lai SML. Radiographs in periodontal disease diagnosis and management. Aust Dent J 2009; 54 Suppl 1:S27-43. [DOI: 10.1111/j.1834-7819.2009.01141.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nackaerts O, Jacobs R, Quirynen M, Rober M, Sun Y, Teughels W. Replacement therapy for periodontitis: pilot radiographic evaluation in a dog model. J Clin Periodontol 2008; 35:1048-52. [DOI: 10.1111/j.1600-051x.2008.01333.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Brook A Niemiec
- Southern California Veterinary Dental Specialties, San Diego, CA 92111, USA.
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