Diagnostic Accuracy of Charge-coupled Device Sensor and Photostimulable Phosphor Plate Receptor in the Detection of External Root Resorption In Vitro

Image Quality, Radiation Dose, and Patient Comfort Associated with Wireless Sensors in Digital Radiography: A Systematic Review

Radiography facilities face challenges with the positioning of digital radiography detectors. This study evaluates the image quality, radiation dose, and patient comfort associated with wireless sensors in digital radiography. A systematic exploration was performed across PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, and SCIELO. Nine papers met the eligibility criteria, including three observational studies with 111 patients, four in vitro experiments with 258 extracted human teeth, and two ex vivo investigations with 16 cadaver mandibles. All studies consistently reported high-quality images produced by wireless sensors. Two studies demonstrated the superiority of wireless sensors, one found comparable accuracy with conventional radiography, and another indicated similar image quality among the sensors. Both wireless and wired sensors significantly reduced radiation doses compared to conventional X-rays. The Visual Analog Scale (VAS) did not reveal a clear superiority of wireless over wired sensors, though both were generally less comfortable than traditional film. The wireless sensors consistently produce high-quality images, comparable to or superior to other digital devices. Both wireless and wired sensors significantly reduce radiation doses compared to conventional X-rays, emphasizing their safety and efficacy. Patient comfort levels vary, with neither sensor type showing clear superiority over the other, and both being less comfortable than traditional film.

Does enhancement filter application increase the diagnostic accuracy of misfit detection at the implant-prosthesis interface?

STATEMENT OF PROBLEM

Misfits at the implant-prosthesis interface may increase complications in dental implants and affect peri-implant tissue health. Periapical radiographs are the most used imaging examinations for detecting misfits at the implant-prosthesis interface, although digital systems have largely replaced film-based radiographs. Whether postprocessing tools such as enhancement filters assist diagnosis by highlighting misfits is unclear.

PURPOSE

The purpose of this in vitro study was to assess the influence of enhancement filter application in the diagnostic accuracy of misfit detection at the implant-prosthesis interface.

MATERIAL AND METHODS

A total of 32 dental implants were placed in dry human mandibles. A polyester strip was inserted at the implant-prosthesis interface to simulate a 50-μm misfit; prosthetic crowns installed directly on the implant platforms were used as controls. Standard paralleling periapical images were acquired by using a semidirect system (photostimulable phosphor plate) with the application of Highlight, Invert, and Colorization filters, as well as a direct system (metal oxide complementary semiconductor sensor) with filters Sharpness 3, Invert, and Pseudocolorization. Oral radiologists evaluated the images with and without the application of filters. The areas under the receiver operating characteristics curves (Az values), sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were calculated. The Az values were compared with the receiver operating characteristic (ROC) curves comparison test of the Epidat 3.1 software (α=.05).

RESULTS

Although images without filter application presented descriptively higher diagnostic values than those with filter application, the Az values for images with and without filter application in both semidirect and direct systems showed no significant differences (P>.05).

CONCLUSIONS

Enhancement filter application did not significantly influence the diagnostic accuracy of misfit detection at the implant-prosthesis interface.

Influence of radiographic acquisition methods and visualization software programs on the detection of misfits at the implant-abutment interface: An ex vivo study

STATEMENT OF PROBLEM

Misfits at the implant-prosthesis interface may compromise implant-supported prostheses. Periapical radiographs are frequently used to detect misfit and can be obtained by using digital or film-based systems; however, which radiographic acquisition method and visualization software program provides the greatest accuracy is unclear.

PURPOSE

The purpose of this ex vivo study was to evaluate the influence of 3 radiographic acquisition methods (complementary metal oxide semiconductor [CMOS] sensor, phosphor plates, and radiographic films) and 2 visualization software programs (proprietary and third-party) on the detection of misfits at the implant-prosthesis interface.

MATERIAL AND METHODS

Thirty-two dental implants were placed in dry human mandibles. Misfits were simulated by inserting a 50-μm polyester strip at the implant-prosthesis interface; prosthetic crowns installed directly over the implant platforms were considered as controls. Standard parallel periapical radiographs were obtained by using a CMOS sensor, a phosphor plate, and radiographic films. Five dentists assessed the digital radiographs for the presence or absence of misfits at the implant-prosthesis interface by using the proprietary software program and a third-party software program; film-based radiographs were evaluated on a light box. The area under the receiver operating characteristic curves (Az values) were compared (α=.05); sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were also estimated.

RESULTS

All diagnostic and Az values were higher for the phosphor plate than for the CMOS sensor and the film-based methods (P<.05), regardless of the viewing software program used (proprietary or third-party) (P>.05).

CONCLUSIONS

The use of phosphor plates positively influenced the diagnostic accuracy for the detection of misfits at the implant-prosthesis interface, irrespective of the viewing software program used.

Numerical Evaluation of Image Contrast for Thicker and Thinner Objects among Current Intraoral Digital Imaging Systems

The purpose is to evaluate the performance of current intraoral digital detectors in detail using a precise phantom and new method. Two aluminum step wedges in 0.5 mm steps were exposed by two photostimulable phosphor plate (PSP) systems—one with automatic exposure compensation (AEC) and the other without AEC—and a CCD sensor. Images were obtained with 3 doses at 60 kV. The effect of metallic material also was evaluated. The contrast-to-noise ratio (CNR) for thinner steps and the low contrast value (LCV) for thicker steps were obtained. The CCD system was the best under all conditions (P < 0.001), although the Gray value was sensitive to the dose, and the Gray value-dose relation varied greatly. The PSP system with AEC was superior to that without AEC for the LCV (P < 0.001) but was inferior to it regarding the CNR (P < 0.001). CNR and LCV in the PSP system without AEC were not affected by the metallic plate. Intraoral digital imaging systems should be chosen according to their diagnostic purpose. PSP system with AEC may be the best for detecting molar proximal caries, whereas the PSP system without AEC may be better for evaluating small bone regeneration in periodontal disease. The CCD system provided the best performance.