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

Radiographic diagnosis of periodontal diseases - Current evidence versus innovations

Accurate diagnosis of periodontal and peri-implant diseases relies significantly on radiographic examination, especially for assessing alveolar bone levels, bone defect morphology, and bone quality. This narrative review aimed to comprehensively outline the current state-of-the-art in radiographic diagnosis of alveolar bone diseases, covering both two-dimensional (2D) and three-dimensional (3D) modalities. Additionally, this review explores recent technological advances in periodontal imaging diagnosis, focusing on their potential integration into clinical practice. Clinical probing and intraoral radiography, while crucial, encounter limitations in effectively assessing complex periodontal bone defects. Recognizing these challenges, 3D imaging modalities, such as cone beam computed tomography (CBCT), have been explored for a more comprehensive understanding of periodontal structures. The significance of the radiographic assessment approach is evidenced by its ability to offer an objective and standardized means of evaluating hard tissues, reducing variability associated with manual clinical measurements and contributing to a more precise diagnosis of periodontal health. However, clinicians should be aware of challenges related to CBCT imaging assessment, including beam-hardening artifacts generated by the high-density materials present in the field of view, which might affect image quality. Integration of digital technologies, such as artificial intelligence-based tools in intraoral radiography software, the enhances the diagnostic process. The overarching recommendation is a judicious combination of CBCT and digital intraoral radiography for enhanced periodontal bone assessment. Therefore, it is crucial for clinicians to weigh the benefits against the risks associated with higher radiation exposure on a case-by-case basis, prioritizing patient safety and treatment outcomes.

Evaluation of Two Dental Digital Imaging Systems Based on Quality Scorings, Burn-Out Effects and Cervical Width Determination

Background/Aim: The aim of the present study is to evaluate diagnostic accuracy of two generic image receptors with CMOS and PSP sensors for image quality scoring (IQS), burnout incidences (BI) and cervical widths (CW) with regard to four different exposure times.

Material and Methods: 43 incisor teeth within 15 paraffin block models were exposed at 4 different exposure times both for the CMOS and PSP groups, and a total number of 120 images were obtained. All images were evaluated by 3 dentomaxillofacial radiologists via 3 different criteria; IQS, BI, CW.

Results: Diagnostic quality scorings between groups displayed statistically significant difference for 0,1; 0,125 and 0,16 sec exposure times. PSP group revealed higher IQS. For 0,125 and 0,16 seconds exposure times, PSP group showed higher percentages of BI. Average CW were lower in PSP group. Although no statistically significant difference was found between average CW vs. exposure times in the CMOS group; PSP group revealed significant differences among exposure times. We can state that, the PSP system displayed higher image quality so exposure times can be reduced, alas, the same conclusion is not possible with CMOS system used.

Conclusions: Image quality perception is higher in PSP system we used, compared with CMOS system. PSP system display more burnout effects with increasing exposure times, while CMOS system is constant.

The Effects on Absorbed Dose Distribution in Intraoral X-ray Imaging When Using Tube Voltages of 60 and 70 kV for Bitewing Imaging

Objectives

Efforts are made in radiographic examinations to obtain the best image quality with the lowest possible absorbed dose to the patient. In dental radiography, the absorbed dose to patients is very low, but exposures are relatively frequent. It has been suggested that frequent low-dose exposures can pose a risk for development of future cancer. It has previously been reported that there was no significant difference in the diagnostic accuracy of approximal carious lesions in radiographs obtained using tube voltages of 60 and 70 kV. The aim of this study was, therefore, to evaluate the patient dose resulting from exposures at these tube voltages to obtain intraoral bitewing radiographs.

Material and Methods

The absorbed dose distributions resulting from two bitewing exposures were measured at tube voltages of 60 and 70 kV using Gafchromic^® film and an anatomical head phantom. The dose was measured in the occlusal plane, and ± 50 mm cranially and caudally to evaluate the amount of scattered radiation. The same entrance dose to the phantom was used. The absorbed dose was expressed as the ratio of the maximal doses, the mean doses and the integral doses at tube voltages of 70 and 60 kV.

Results

The patient receives approximately 40 - 50% higher (mean and integral) absorbed dose when a tube voltage of 70 kV is used.

Conclusions

The results of this study clearly indicate that 60 kV should be used for dental intraoral radiographic examinations for approximal caries detection.