• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.432-438
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• 2017

PURPOSE. The purpose of this study was to evaluate the in vitro validity of quantitative light-induced fluorescence-digital (QLF-D) and laser fluorescence (DIAGNOdent) for assessing proximal caries in extracted premolars, using digital radiography as reference method. MATERIALS AND METHODS. A total of 102 extracted premolars with similar lengths and shapes were used. A single operator conducted all the examinations using three different detection methods (bitewing radiography, QLF-D, and DIAGNOdent). The bitewing x-ray scale, QLF-D fluorescence loss (${\Delta}F$), and DIAGNOdent peak readings were compared and statistically analyzed. RESULTS. Each method showed an excellent reliability. The correlation coefficient between bitewing radiography and QLF-D, DIAGNOdent were -0.644 and 0.448, respectively, while the value between QLF-D and DIAGNOdent was -0.382. The kappa statistics for bitewing radiography and QLF-D had a higher diagnosis consensus than those for bitewing radiography and DIAGNOdent. The QLF-D was moderately to highly accurate (AUC = 0.753 - 0.908), while DIAGNOdent was moderately to less accurate (AUC = 0.622 - 0.784). All detection methods showed statistically significant correlation and high correlation between the bitewing radiography and QLF-D. CONCLUSION. QLF-D was found to be a valid and reliable alternative diagnostic method to digital bitewing radiography for in vitro detection of proximal caries.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.1013-1023
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• 2018

Objectives: The purpose of this study is to evaluate dental hygiene students' recognition of safety management and phantom practice in dental radiology. Methods: The study subjects were 409 students in six regions who completed a dental radiology practice course and had on-job experience more than once. After understanding the study purpose and contents, they answered a questionnaire. The main jobs in dental radiology were analyzed. Results: As a result, regarding the most difficult aspects of dental radiology practice, "it is impossible to irradiate the mouth directly with X-rays" was the most common response (29.1%). Regarding the question "what is the main role of students in dental radiology practice?", the answer "it is shooting simulations using phantoms" accounted for 59.7% of responses. The most difficult regions in bisecting and paralleling radiography with a phantom were found to be the maxillary & mandibular molars and premolars. The most difficult technique was reported to be locating XCP maintenance to fit inside the mouth for both molars and premolars. The most difficult region to perform bitewing radiography using the phantom was the molar region (2.87), and the most difficult to perform occlusal radiography approaches were maxillary anterior general occlusal radiography (2.92) and mandibular cross-sectional occlusal radiography (3.00). Conclusions: The most technically difficult point in bitewing and occlusal radiography was the correct positioning of the vertical and horizontal angles. Radiography practice was considered to be more effective than previous mutual practice in terms of analysis of anatomical structures and patient treatment methods. Therefore, it will be necessary to improve policy regarding dental radiography practice at the department of dental hygienics and revise the necessary laws and regulations.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.271-278
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• 1987

The purpose of the present study was to investigate associations between periapical and bitewing techniques by assessing the crestal alveolar bone. This article also reports the ability of these two techniques to correctly detect evidence of interproximal dental caries, and comparison between the interproximal overlapping of teeth. Bitewing and periapical radiographs were used from posterior quardants of 243 dental students in Seoul National University. The distance from cemento-enamel junction to the alveolar crest (CEJ-AC) was measured for each proximal surface from the distal of cuspid to the distal of second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows: 1. In maxilla, a significant t ratio with a P value of 0.05 or less reached for 100% and in mandible, reached for 94%. 2. The anatomic limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 3. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used. 4. The number of the interproximal overlapping was the largest medial side of the maxillary second molar, while the smallest at the distal side of the mandibular second premolar. And the overall number of the interproximal overlapping was more (538) in the periapical technique than in the bitewing technique (372). 5. The interproximal dental carious lesions were detected more (74) on the bitewing films than on the periapical ones (23). The fact was resulted from the small number of interproximal overlapping and relative easi- ness of obtaining horizontal angulation in taking the bitewing radiographs.

• Imaging Science in Dentistry
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• v.41 no.4
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• pp.143-150
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• 2011

Purpose : The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. Materials and Methods : One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve ($A_z$) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). Results : The mean $A_z$ values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest $A_z$ value. Conclusion : Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.

• Imaging Science in Dentistry
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• v.48 no.2
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• pp.87-96
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• 2018

Purpose: The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods: Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results: For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations(P>.05), but showed no discriminatory ability for amalgam restorations(P<.05). Conclusion: Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.222-226
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• 2014

Purpose: This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. Methods: Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. Results: This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. Conclusions: Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Journal of Korean society of Dental Hygiene
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• v.4 no.1
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• pp.49-64
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• 2004

This study is designed to conduct a questionnaire research into the safety control and the actual condition of radiography by working with dentistry belonging to university hospitals, dental hospitals and dental clinics for three months ranging from August, 2003 to October, 2003. The researcher came to the following conclusions. 1. The research on the current condition of possessed radiational equipment shows that 61.2 percent of the subjects had one intraoral radiation medicine and that 70.1 percent of the subjects had more than one extraoral radiation medicine and that 37.3 percent of the subjects had more than one digital radiation medicine. 2. Most of intraoral radiography (82.1%) was conducted by dental hygienists, and 7.5 percent of intraoral radiography was conducted by nurse aids. On the other hand, most of extraoral radiography (76.6%) was conducted by dental hygienists and digital radiography was conducted by dental hygienists(60.6%), dentists(32.0%) and radiographer(80.0%). 3. The less-than 1-meter-long distance between cone and the radiographer accounted for 44.8 percent. And the more-than 1.6-meter-long distance accounted for no more than 13.4 percent. The exposure time per standard film which was adjusted to each part accounted for 71.6 percent. Fixing the film on the part of healthy patients accounted for 76.1 percent. Fixing the film of elderly patients and children patients by the radiographer accounted for 43.3 percent. 4. The average daily photographing frequency of standard films stood at six to ten pieces(31.3%), and the average weekly photographing frequency of bitewing films stood at less than one piece(47.8%), and the dentistries where bitewing films were not employed accounted for 25.4%. The subjects whose average weekly photographing freqeuncy of occlusal films stood at less than a piece accounted for 59.7 percent. The dentistries whose average weekly photographing frequency of pediatric films stood at one to five pieces accounted for 41.8 percent. In case of panorama & cephalo, one to five pieces on a weekly average accounted for 36.2 percent. The dentistries whose average daily photographing frequency of digital radiation medicine stood at less than 1 piece accounted for 40.0 percent. 5. The research on the use of protective clothes shows that pregnant ·women only accounted for 31.3 percent. In regard to the use of protective clothes in case of the radiographers fixing films, the cases where no protective clothes were employed accounted for 88.1 percent. The reason was said to he attributable to the trouble related to wearing the clothes(54.2%). 6. The survey on the measurement of exposure dose shows that the cases where no measurement was made accounted for 76.1 percent. As far as the measurement methods of exposure dose was concerned, the employment of film badge accounted for 68.8 percent. The subjects turned out to conduct measurement of exposure dose every third month, which accounted for 43.8 percent. The barriers to the measurement of measurement of exposure dose were attributable to the recognition that a little amount of exposure dose need not be measured(29.9%). 7. The survey on the distinction of radiation rooms and clinic rooms reveals that the cases where radiation rooms exclusively existed accounted for 67.2 percent. 43.3 percent of the subjects turned out to have only one protective garment, and 49.3 percent of the subjects proved to conduct a periodical checkup of radiational equipment. The survey on the examination certificates of radiational generators and protective facilities indicates that 80.6 percent of the subjects had the certificates. The research also shows that the subjects with the marks indicating the radiational areas accounted for 70.1 percent. And trustees turned out to handle developing solutions and fixing solutions.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.405-413
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• 2021

The purpose of this in vivo study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography. Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels. Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries. The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

• Imaging Science in Dentistry
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• v.30 no.1
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• pp.49-54
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• 2000

Purpose : To compare the diagnostic performance of clinical and radiologic examination for the interproximal caries on intraoral periapical radiographs and to evaluate the value of periapical radiographs. Methods: One hundred seven dental patients were examined clinically, with a mouth mirror and an explorer, by a dentist at the department of oral medicine, and the presence or absence of interproximal caries lesion was recorded. The patients were prescribed one or more dental periapical radiographs. Radiographs were assessed for the presence of interproximal caries by three oral and maxillofacial radiologists independantly. Two thousand sixty interproximal surfaces were included in this study. The diagnostic accuracies of clinical and radiologic examinations for interproximal caries were calculated. To assess the degree of agreement between clinical and radiologic examinations, Cohen's coefficient of agreement was computed. Results: The specificity of clinical and radiologic examination was 0.991, 0.997 and the sensitivity was 0.279, 0.985 respectively. The diagnostic accuracy of radiologic examination was statistically significantly higher than that of clinical examination (P<0.05). Cohen's kappa value of clinical and radiologic examination was 0.335, 0.942 respectively. These results suggested that clinical examination show only fair agreement, whereas radiologic examination show perfect agreement. Conclusion: The diagnositic performance of the dental periapical radiographs on interproximal caries were higher than that of clinical examination, thus this study showed the validity of periapical radiographs for detecting interproximal caries lesion without bitewing radiograph.