This study analyzes through the review of literature and laws the exposure time, clinical frequency, and radiation exposure of intraoral and extraoral radiography as well as of panoramic radiography performed by dental hygienists in dental clinics, compares the dental radiology curriculums of radiological science and dental hygiene departments, and proposes the expansion of dental hygienists' radiography operations. The radiology curriculums were compared between the radiological science and dental hygiene departments of colleges. For new analysis by radiography for dental diagnosis, the exposure time, radiation absorbed dose, effective dose, and number of days of natural radiation were compared by the type of oral radiation films and radiographical techniques proposed by domestic and international studies. The exposure time of panoramic radiography is 15 seconds and it takes about two minutes for completion, whereas the exposure time of the standard radiography is 0.2~0.8 seconds and it takes 10 times longer for completion of the radiography of full mouth than the panoramic radiography. The standard radiography can cause distortions of radiation at severely curved parts of dental arch and palatopharyngeal reflex. However, panoramic radiography can be performed even for lock jaw patients, causes less inconvenience to patients and is much simpler than the standard radiography. The percentage of dental clinics where radiography is performed by dental hygienists was 92.0%, and the percentage of standard film radiography by dental hygienists was 98% whereas the percentage of panoramic radiography by dental hygienists was 92%. For the absorbed dose which is an indicator of radiation exposure, the When the effective dose which is an indicator of the danger of radiation exposure was converted to the number of days of natural radiation, it was 3.3 days for panoramic radiography, but 13.9 days for the full mouth standard radiography by bisecting angle technique which was 4.2 times longer than the panoramic radiography. There were two colleges that had a dental radiology course with two credits in the departments of radiological science. The credits for dental radiology courses in the department of dental hygiene ranged varied by college, ranging from 3 to 8; on average, the theory course was 2.2 credits and the practice course was 2.02 credits. To summarize the above results, the percentage of dental clinics where panoramic radiography is performed by dental hygienists under the guidance of dentists is high. Panoramic radiography has become an essential facility for dental clinics. It is faster than standard film radiography and less dangerous due to low radiation exposure. Panoramic radiography is a simple mechanical job that does not require training of oral radiography by radiotechnologist. Because panoramic radiography is one of major operations which must be performed at all times in dental clinics, it must be designated as intraoral technique rather than extraoral technique, or legalized for inclusion in the scope of operations of dental hygienists.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.5
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pp.504-510
/
2007
Purpose: The purpose of this study was to determine the incidence of antral septa and the accuracy of panoramic radiograph in identifying maxillary sinus septa. In addition, when panoramic radiograph led to a false diagnosis of more than majority, we analyzed findings of the panoramic radiograph. Patients and methods: This study included 180 patients who were radiographically examined before the surgery was done using both panoramic and computerized tomographic radiographs(CT scan), Samsung Medical Center from April 2003 to March 2006, and examined the incidence of antral septa, the false diagnosis rate of panoramic radiograph, and radiographic characters in case of false diagnosis. Only those bone lamellae were considered as septa that showed a height of at least 3.0mm. It was thus possible to exclude the alveolar recess. One oral and maxillofacial surgeon(OMFS) determined the presence or absence of sinus septa in CT scan, and five OMFS determined the presence or absence of sinus septa in panoramic radiograph. Results: The septa were observed in 81 of 360 sinuses(22.5%). All septa were oriented in a buccopalatal plane. More or less greater prevalence was observed in the second molar region(38.2%) but no predominant location was found. Panoramic radiograph led to false diagnosed septa in 361 of 1800 cases(20.1%). In case of false diagnosis of more than majority, superimposed image on zygomatic process was 44.1%, faint image in the region not related to sinus lifting 26.5%, faint image in the region related to sinus lifting 17.6%, and misconception for superimposed image 11.8% Conclusion: In this study we could get clinico-anatomical information of septum in the maxillary sinus. Compared to CT scan, panoramic radiograph can not clearly differentiate the sinus septa, but we consider that panoramic radiograph may improve its usefulness if we take additional modified panoramic radiograph and clinical exam.
Purpose : This study was designed to evaluate the efficacy and utility of panoramic radiograph for the improvement of the periodic oral examinations. Materials and Methods : Clinical examinations and panoramic examinations were done for the 242 subjects of oral examinations. The results of panoramic radiograph interpretation were compared with the clinical findings. Two questionnaires were created. One was carried out before the panoramic examination and the other done afterwards, to find out the subjects' cognition and satisfaction for the clinical and panoramic examinations. Results : 1. Panoramic findings showed a higher detection rate of 31.9% for periodontal diseases, and 23.1% for dental caries than clinical findings. 2. The additional abnormalities detected through panoramic examinations were impacted tooth in 81 subjects (33.6%), maxillary sinus abnormalities in 28 subjects (11.6%), condylar abnormalities in 5 subjects (2.1%), congenital and acquired dental anormalies in 59 subjects (24.5%), and other miscellaneous abnormalities in 34 subjects (14.1%). 3. 164 subjects (67.8%) were satisfied with the current periodic oral examination, and 75 subjects (31.1%) hoped for better accuracy. 4. In the first and second questionnaire, 154 subjects (67.0%) and 163 subjects (70.6%) responded respectively that panoramic examination was necessary, and 193 subjects (83.2%) responded that it actually helped. Conclusion : The panoramic examination was revealed to improve the effectiveness of the periodic oral examination and to increase the satisfaction of the subjects of examination.
PURPOSE. This study compared the SCGAs measured in three types of radiographic images (panoramic, CBCT panoramic-section, and CBCT cross-section images) with values measured using the protrusive occlusal record. MATERIALS AND METHODS. SCGAs were measured in 20 patients on a semi-adjustable articulator using the protrusive interocclusal record. Panoramic and CBCT images were obtained. SCGAs were measured on CBCT images in panoramic and cross sections. In all of the radiographic images, SCGAs were measured using the Frankfort horizontal reference line and the mean curvature line. The most-superior and most-inferior points of the curvatures were identified to determine the mean curvature line. Each measurement was performed twice by two operators independently. The data were analyzed by the t-test, Pearson's correlation test, and Cronbach's ${\alpha}$ using SPSS (${\alpha}=.05$). RESULTS. The mean right and left SCGAs were as follows: protrusive occlusal record (30.1 and 30.2 degrees, respectively), panoramic (38.9 and 38.7 degrees), CBCT panoramic sections (35.4 and 36.8 degrees), and CBCT cross sections (35.3 and 36.1 degrees). The SCGAs differed significantly among the groups. The Pearson coefficients for the correlations with the protrusive occlusal record measurements on the left and right sides were as follows: panoramic (0.834 and 0.791, respectively), CBCT panoramic-section (0.918 and 0.837), and CBCT cross-section (0.918 and 0.845) images. CONCLUSION. Strong correlations were found between SCGAs obtained using radiographic images and the protrusive occlusal record.
Purpose: This study was performed to investigate the course of the mandibular canal on panoramic radiography and the visibility of this canal on both panoramic radiography and cone-beam computed tomography (CBCT). Materials and Methods: The study consisted of panoramic radiographs and CBCT images from 262 patients. The course of the mandibular canal, as seen in panoramic radiographs, was classified into four types: linear, elliptical, spoon-shaped, and turning curves. The visibility of this canal from the first to the third molar region was evaluated by visually determining whether the mandibular canal was clearly visible, probably visible, or invisible. The visibihlity of the canal on panoramic radiographs was compared with that on CBCT images. Results: Elliptical curves were most frequently observed along the course of the mandibular canal. The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves and the lowest among the linear curves. On panoramic radiographs, invisible mandibular canals were found in 22.7% of the examined sites in the first molar region, 11.8% in the second molar region, and 1.3% in the third molar region. On CBCT cross-sectional images, the mandibular canal was invisible in 8.2% of the examined sites in the first molar region, 5.7% in the second molar region, and 0.2% in the third molar region. Conclusion: The visibility of this canal was lower in the first molar region than in the third molar region. The mandibular canal presented better visibility on CBCT images than on panoramic radiographs.
Dental panoramic radiography is an imaging technique which shows the information of teeth, jaws and superficial structures on a single image. In this study, we propose the clinical dose reference for dental panoramic radiography. Dental panoramic radiography is an application which can increase the radiation does of oral cavity. It is very important to study the real condition of management for these panoramic X-ray equipments. Since there was no researches on dental panoramic equipments in domestic and foreign study groups, we measured and analyzed the dose such as effective dose, DAP and DWP of panoramic radiography.
Purpose: This study evaluated the association between cone beam computed tomography (CBCT) and panoramic radiographs in the assessment of a superimposed relationship between the mandibular canal and impacted third molars. Materials and Methods: The study samples consisted of 175 impacted third molars from 131 patients who showed a superimposed relationship between the mandibular canal and third molars on panoramic radiographs and were referred for the examination of the mandibular canal with CBCT. Panoramic images were evaluated for the darkening of the root and the interruption of the mandibular canal wall. CBCT images were used to assess the buccolingual position of the mandibular canal relative to the third molar, the proximity of the roots to the canal, and lingual cortical bone loss. The association of the panoramic and CBCT findings was examined using a Chi-square test and Fisher's exact test. Results: Panoramic radiographic signs were statistically associated with CBCT findings (P<0.01). In cases of darkening roots, lingual cortical bone loss or buccally positioned canals were more frequent. In cases in which the mandibular canal wall was interrupted on panoramic radiographs, contact or lingually positioned canals were more frequent. Conclusion: The results of this study suggest that contact between the mandibular third molar and canal and a lingually positioned canal could be more frequently observed in cases of the interruption of the white line of the mandibular canal and that there could be more lingual cortical loss in cases of darkening roots.
Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.
Purpose : To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. Materials and Methods: We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as "no treatment indicated", "treatment of dental caries", "removal of calculus", "treatment of periodontal disease", "prothodontic treatment" and "extraction of the third molar". Findings taken from the panoramic radiography were: dental caries, periapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. Results: The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition, 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of diseases of maxillary sinus, 2.1 % of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. Conclusion: The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.
Ozalp, Oznur;Tezerisener, Huseyin Alican;Kocabalkan, Burak;Buyukkaplan, Ulviye Sebnem;Ozarslan, Mehmet Mustafa;Kaya, Goksel Simsek;Altay, Mehmet Ali;Sindel, Alper
Imaging Science in Dentistry
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v.48
no.4
/
pp.269-275
/
2018
Purpose: The aim of this study was to evaluate the correlations between measurements made using panoramic radiography and cone-beam computed tomography (CBCT) based on certain anatomical landmarks of the jaws, with the goal of preventing complications due to inaccurate measurements in the pre-surgical planning phase of dental implant placement. Materials and Methods: A total of 56 individuals who underwent panoramic radiography and a CBCT evaluation before dental implant surgery were enrolled in the study. Measurements were performed to identify the shortest vertical distance between the alveolar crest and neighboring anatomical structures, including the maxillary sinus, nasal floor, mandibular canal, and foramen mentale. The differences between the measurements on panoramic radiography and CBCT images were statistically analyzed. Results: Statistically significant differences were observed between the measurements on panoramic radiography and CBCT for all anatomical structures (P<.05). The correlation coefficients (r) between the paired samples obtained from panoramic radiography and CBCT were closely correlated (P<.05), with r values varying from 0.921 and 0.979 for different anatomical regions. Conclusion: The results of this study support the idea that panoramic radiography might provide sufficient information on bone height for preoperative implant planning in routine cases or when CBCT is unavailable. However, an additional CBCT evaluation might be helpful in cases where a safety margin cannot be respected due to insufficient bone height.
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