Digital radiographic systems allow the implementation of a fully digital picture archiving and communication system (PACS), and provide the greater dynamic range of digital detectors with possible reduction of X-ray exposure to the patient. This article reviewed the basic physical principles of digital radiographic imaging system in dental clinics generally. Digital radiography can be divided into computed radiography (CR) and direct radiography (DR). CR systems acquire digital images using phosphor storage plates (PSP) with a separate image readout process. On the other hand, DR systems convert X-rays into electrical charges by means of a direct readout process. DR systems can be further divided into direct and indirect conversion systems depending on the type of X-ray conversion. While a direct conversion requires a photoconductor that converts X-ray photons into electrical charges directly, in an indirect conversion, lightsensitive sensors such as CCD or a flat-panel detector convert visible light, proportional to the incident X-ray energy by a scintillator, into electrical charges. Indirect conversion sensors using CCD or CMOS without lens-coupling are used in intraoral radiography. CR system using PSP is mainly used in extraoral radiographic system and a linear array CCD or CR sensors, in panoramic system. Currently, the digital radiographic system is an important subject in the dental field. Most studies reported that no significant difference in diagnostic performance was found between the digital and conventional systems. To accept advances in technology and utilize benefits provided by the systems, the continuous feedback between doctors and manufacturers is essential.
Purpose : Hand-held dental x-ray system is a self contained x-ray machine designed to perform intraoral radiography with one or two hands. The issue about its usage as general dental radiography is still in dispute. The aim of the present study was to assess the relationship between the amount of battery charge and the tube voltage in different handheld dental x-ray systems. Materials and Methods : Seven hand-held dental x-ray units were used for the study. Tube voltage was measured with Unfors ThinX RAD (Unfors Instruments AB, Billdal, Sweden) for 3 consecutive exposures at the different amount of battery charge of each unit. The average and the deviation percentage of measured kV from indicated kV of each unit were calculated. Results : Tube voltage of only 1 unit was 70 kV (indicated by manufacturer) and those of the others were 60 kV. Tube voltage deviation percentage from the indicated kV at the fully charged battery was from 2.5% to -5.5% and from -0.8% to -10.0% at the lowest charged battery. Conclusion : Tube voltages of all units decreased as the residual amount of the battery charge decreased. It is suggested that the performance test for hand-held x-ray system should be performed for the minimum residual charged battery as well as the full charged one. Persistent battery charging is suggested to maintain the proper tube voltage of the hand-held portable x-ray system.
To investigate the perceptions and attitudes of dental hygienists toward radiation safety management in Korea. A total of 800 dental hygienists were randomly selected for an anonymous survey, and 203 of them participated. The questionnaire items included the following: sex, career period, type of installed radiographic equipment, recognition of the diagnostic reference level (DRL), participation in radiation safety education, and attitudes toward radiation protection for both patients and dental hygienists. The participants were divided into two groups according to their years of experience (< 10 years versus ≥ 10 years). The difference between the groups was investigated according to frequency distribution. Fisher's exact test or Pearson's chi-square (𝛘2) test was used as appropriate. A regression analysis was performed to investigate the impact of wearing a thyroid collar for personnel protection during patient radiation exposure. The types of installed radiographic equipment included panoramic radiography (96.1%), cephalometric radiography (76.9%), intraoral radiography (72.9%), and cone-beam computed tomography (69.5%). Significant differences were observed in the learning pathway for the DRL (Fisher's exact test, p < 0.05), satisfaction with radiation safety education (Pearson's 𝛘2 test = 5.3975, Pr = 0.02), and use of personnel radiation monitoring systems (Pearson's 𝛘2 test = 18.1233, Pr = 0.000) between the groups. Significant differences were also observed in personnel protection using a thyroid collar and patient protection during panoramic radiography (odds ratio = 14.2). Dental hygienists with more than 10 years of experience were more satisfied with radiation safety education and more interested in radiation monitoring. Considering career experience, customized, continuous, and effective radiation safety management education should be provided.
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.
Purpose: X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. Materials and Methods: The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. Results: The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. Conclusion: The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.
This study was performed to measure the skin absorbed doses from full mouth standard intraoral radiography (l4 exposures) in bisecting angle and paralleling techniques. Thermoluminescent dosimeters were used in a phantom. Circular tube collimator(60㎜ in diameter, 20㎝ in length) and rectangular collimator(35㎜ × 44㎜, 40㎝ in length) were set for bisecting angle and paralleling techniques respectively. All measurement sites were classified into 8 groups according to distance from each point of central rays. The results were as follows: 1. The skin absorbed doses from the paralleling technique were significantly decreased than those from the bisecting technique in both points at central ray and points away from central ray. The percentage rates of decrease were greater at points away from central ray than those at central ray. 2. The skin absorbed doses at the lens of eye, parotid gland, submandibular gland and thyroid region were significantly decreased in paralleling techniuqe, but those of the midline of palate remained similar in both techniques. 3. The highest doses were measured at the site 20mm above the point of central ray for the mandibular premolars in bisecting angle technique and at the point of central ray for the mandibular premolars in paralleling techniques. The lowest doses were measured at the thyroid region in both techniques.
Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient s exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images(unenhanced image, brightness & contrast controlled image, and edge enhanced image). ROC(Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowermost in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.
Since $Gr{\"{o}}nadhl$ et al introduced a digital subtraction radiography into periodontal dignosis in 1983, many reports using this system has aimed to assess the peroiodontal disease activity and the alveolar bone changes after periodontal treatment. The present study was performed to evaluate the usefulness of digital subtraction radiography for asessing an alveolar bone changes in 3 months after periodontal flap surgery. Serial intraral raiographs were taken from 5 normal subjects and 6 periodontally diseased patients using customized bite blocks attached to film holder in fxation device and digitized by image processing system(consisting of IBM 386, digital frame grabber, CCD camera, Image-pro II software). And the reference parameters were measured by pixel unit and compared with respective radiographs. The serial radiographs showed a little and statistically insignificant difference in reference paramenters. The conventional intraoral radiographs, the subtraction images and the clor enhanced subtraction images were reviewed by 4 examiners and the examiner's agreement rates were compared. The subtraction images and its color enhanced images showed higher examiner's agreement rate than the conventional radiographs. And the propotions of sites diagnosed with bone loss or gain after periodontal surgery were highter in the subtraction images and its color enhanced images than in the conventional radiographs. Especially, in color enhanced images, the unber of bone agin sites tended to increase according to post-surgery periods. These results indicate that projection geometry could be standardized with the divice used in this study, and the subtraction radiography may be useful to assess an alveolar bone changes after periodntal flap surgery.
Han-Gyeol Yeom;Jo-Eun Kim;Kyung-Hoe Huh;Won-Jin Yi;Min-Suk Heo;Sam-Sun Lee
Imaging Science in Dentistry
/
제53권4호
/
pp.345-353
/
2023
Purpose: The objective of this study was to propose a method for developing a clinical phantom to reproduce various diseases that are clinically prevalent in the field of dentistry. This could facilitate diverse clinical research without unnecessarily exposing patients to radiation. Materials and Methods: This study utilized a single dry skull, which was visually and radiographically examined to evaluate its condition. Existing lesions on the dry skull were preserved, and other relevant lesions were artificially created as necessary. These lesions were then documented using intraoral radiography and cone-beam computed tomography. Once all pre-existing and reproduced lesions were confirmed by the consensus of 2 oral and maxillofacial radiologists, the skull was embedded in a soft tissue substitute. To validate the process, cone-beam computed tomography scans and panoramic radiographs were obtained of the fabricated phantom. All acquired images were subsequently evaluated. Results: Most lesions could be identified on panoramic radiographs, although some sialoliths and cracked teeth were confirmed only through cone-beam computed tomographic images. A small gap was observed between the epoxy resin and the bone structures. However, 2 oral and maxillofacial radiologists agreed that this space did not meaningfully impact the interpretation process. Conclusion: The newly developed phantom has potential for use as a standardized phantom within the dental field. It may be utilized for a variety of imaging studies, not only for optimization purposes, but also for addressing other experimental issues related to both 2- and 3-dimensional diagnostic radiography.
Purpose: To evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus and periapical, periodontal lesions and to clarify the usefulness of the reconstructed 3-dimensional images to the dental clinical aspects. Materials and Methods: 33 sides of maxillae of the hemi-sectioned Korean heads were used in this study. Periapical radiographs, computed tomography and DentaScan reformatted cross-sectional images were taken for the radiographic evaluation of the peiapical and peiodontal lesions of the maxillary teeth and inferior wall of maxillary sinus. Results : Compared the degree of accuracy and findings of dental and periapical pathoses on the intraoral radiographs and DentaScan reformatted images with the cross-sectioned specimens, the DentaScan reformatted cross-sectional images were more accurate and more effective than the intraoral radiography with a viewpoint of the detection of dental and periapical pathoses. Conclusion: Comparing the lesions of specimens with intraoral radiographies and DentaScan reformatted images, the dental and periodontal pathoses and topographical structures were more clearly observed in the DentaScan reformatted images, providing the possibility of more applications of reformatted images to clinical dentistry.
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