Comparison of two imaging modalities: F-speed film and digital images for detection of osseous defects in patients with interdental vertical bone defects

The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

Purpose

This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs.

Materials and Methods

Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections 5 µm in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (α=0.05).

Results

Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p<0.05). However, no statistically significant differences were found regarding specificity, positive predictive value, negative predictive value, or accuracy (p>0.05).

Conclusion

The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

Comparison of diagnostic accuracy of conventional intraoral periapical and direct digital radiographs in detecting interdental bone loss

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.

A Subjective Assessment of Perceived Clarity of Indirect Digital Images and Processed Digital Images with Conventional Intra-oral Periapical Radiographs

OBJECTIVES

To compare and analyze the perceived clarity and diagnostic value of Conventional periapical Radiographs (CRs) with those of their Digitized Periapical Images (DIs) and Processed Digitized Periapical Images (PDIs) counterparts.

MATERIAL AND METHODS

Forty two intraoral periapical radiographs of patients with clinically suspected periapical pathosis were made to constitute the group of CRs. These were photographed by using a Canon Power Shot SD500 (7.1 Megapixel) digital camera and the unaltered images were transferred to a computer laptop, to form the group of DIs. Subsequently, the contrast and brightness of these images were modified to represent the group of PDIs. Two experienced oral radiologists independently evaluated 5 specific apical and periapical region parameters of all the 42 CRs, DIs and PDIs for perceived image quality and diagnostic value and graded them on a three point grading scale. Conventional radiographs served as the control. Data were analyzed by using paired t-test and Kappa analysis.

RESULTS

The clarity and diagnostic quality of the PDIs were statistically significant as compared to those of their conventional counterparts. In comparison, the DIs group fared badly, with deterioration of the image quality. The interobserver agreement was good and all the results were statistically significant.

CONCLUSION

Indirectly digitizing the radiographs by employing a digital camera and further digitally processing the images resulted in an improvement in their perceived clarity and they enhanced their diagnostic properties.

Is there a role for the use of volumetric cone beam computed tomography in periodontics?

Volumetric computed cone beam tomography offers a number of significant advantages over conventional intraoral and extraoral panoramic radiography, as well as computed tomography. To date, periodontal diagnosis has relied heavily on the assessment of both intraoral radiographs and extraoral panoramic radiographs. With emerging technology in radiology there has been considerable interest in the role that volumetric cone beam computed tomography might play in periodontal diagnostics. This narrative reviews the current evidence and considers whether there is a role for volumetric cone beam computed tomography in periodontics.

Influence of individual brightness and contrast adjustment on accuracy of radiographic measurements of infrabony defects

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.

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.