• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.1
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• pp.241-254
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• 1999

The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst & periapical granuloma. The obtained results were as follows; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas. 2. The equivalent circular diameter was over 6.3mm, there was significant difference between periapical cyst and periapical granuloma. 3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile. sensitivity. specificity and accuracy were considerably high(0.83. 0.86. 0.86) respectively. 4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.

• Imaging Science in Dentistry
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• v.33 no.4
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• pp.217-221
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• 2003

Purpose : To evaluate the use of the vertical tube shift from a panoramic film and a periapical film to localize unerupted maxillary incisors and supernumeraries. Materials and Methods : The total of 103 displaced maxillary incisors or embedded supernumeraries were examined in this study. The vertical tube shift technique with panoramic and periapical radiography by normal projection taken and compared to localize the position of the embedded maxillary incisors or supernumeraries by a radiologist and 5 general dentists. The gold standard used for the radiographic comparisons was the true position of the embedded tooth as confirmed by horizontal tube shift technique using three periapical radiographs. The general dentist examiners were instructed on the use of the modified acronym 'SLDOBU' by the radiologist as it pertains to panoramic radiographs as the principle of vertical tube shift. Results: All of the embedded maxillary incisors and supernumeraries were successfully located using the vertical tube shift from a panoramic and a maxillary anterior periapical radiograph by the radiologist and 5 general dentists. Conclusion: The use of a panoramic film with a periapical film combination for a vertical tube shift can be useful to localize unerupted maxillary incisors and supernumeraries.

• Imaging Science in Dentistry
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• v.41 no.4
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• pp.161-165
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• 2011

It is difficult to take intraoral radiographs in some patients who are intolerable to place the film in their mouth. For these patients, Newman and Friedman recommended a new technique of extraoral film placement. Here we report various cases that diagnostic imaging was performed in patients using the extraoral periapical technique. This technique was used to obtain the radiographs for the patients with severe gag reflex, pediatric dental patients, and patients with restricted mouth opening. This technique can be recommended as an alternative to conventional intraoral periapical technique in cases where intraoral film placement is difficult to achieve.

• Imaging Science in Dentistry
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• v.33 no.2
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• pp.71-77
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• 2003

Purpose : To evaluate and compare the efficacy of digital radiographic images in the detection of bone loss at the bifurcation area of the mandibular first molar with traditional film-based periapical radiographs, Materials and Methods : One dried human mandible with minimal periodontal bone loss around the first molar was selected and an artificial alveolar bone defect at the bifurcation area was serially prepared over 18 steps. Images were taken using a direct CCD-based system and with F-speed periapical films. The images were evaluated by seven interpreters (3 radiologists, 3 periodontologists, and 1 general dentist) using a 5-point confidence rating scale. Results : The readability of both periapical radiographs and digital image increased as the size of the artificial lesion and exposure time increased (p < 0.05). Periapical radiographs offered greater readability of smaller bone defects than digital images, and the coefficient of variation of mean score between periapical radiographs and digital images showed a significant difference. Conclusion : The experimental results indicate that a significant difference in the coefficient of variation of mean score exists between periapical radiographs and digital images, and that traditional film-based periapical images offer greater readability of smaller bone defects than digital images can presently offer.

• Imaging Science in Dentistry
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• v.34 no.4
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• pp.185-190
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• 2004

Purpose: To compare the diagnostic accuracy for the detection of root fractures in CMOS-based digital periapical images with conventional film-based periapical images. Materials and Methods: Sixty extracted single-root human teeth with closed apices were prepared endodontically and divided into two groups; artificially induced vertical root fracture group and control group. All radiographs were obtained using the paralleling technique. The radiographs were examined by 4 observers three times within a 4 week interval. Receiver operating characteristic (ROC) analysis was carried out using data obtained from four observers. Intra- and inter-examiner agreements were computed using kappa analysis. Results: The area under the ROC curve (Az) was used as an indicator of the diagnostic accuracy of the imaging system. Az values were as follows: direct-digital images; 0.93, film-based images; 0.92, and inverted digital images; 0.91. There was no significant difference between imaging modalities (P<0.05). The kappa value of inter-observer agreement was 0.42 (range: 0.28-0.60) and intra-observer agreement was 0.57 (range: 0.44-0.75). Conclusion : There is no statistical difference in diagnostic accuracy for the detection of vertical root fractures between digital periapical images and conventional periapical images. The results indicate that the CMOS sensor is a good image detector for the evaluation of vertical root fractures.

• Imaging Science in Dentistry
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• v.35 no.4
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• pp.203-205
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• 2005

Purpose: This study was aimed to compare skin entrance dose of digital radiography with that of film radiography and to show the dose reduction achievement with digital systems at 11 dental schools in Korea. Materials and Methods: Forty six intraoral radiographic systems in 11 dental schools were included in this study. Digital sensors were used in 33 systems and film was used in 13 systems. Researchers and the volunteer visited 11 dental schools in Korea. Researchers asked the radiologic technician (s) at each school to set the exposure parameters and aiming the x-ray tube for the periapical view of the mandibular molar of the volunteer. The skin entrance doses were measured at the same exposure parameters and distance by the technician for each system with a dosimeter (Multi-O-Meter : Unfors instruments, Billdal, Sweden). Results: The median dose was $491.2{\mu}Gy$ for digital radiography and $1,205.0{\mu}Gy$ for film radiography. The skin entrance dose in digital radiography was significantly lower than that of film radiography (p<0.05). Conclusion: Fifty-nine percent skin entrance dose reduction with digital periapical radiography was achieved over the film radiography in Korean dental schools.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.279-290
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• 1994

The purpose of this study was to compare the diagnostic accuracy of periapical radiographs and their digitized images for the detection of simulated interproximal carious lesions. A total of 240 interproximal surfaces was used in this study. The case sample was composed of 80 anterior teeth, 80 bicuspids and 80 molars which were prepared in order to distribute the surfaces from carious free to those containing simulated carious lesions of varying depths (0.5㎜, 0.8㎜, and 1.2㎜). The periapical radiographs were taken by paralleling technique and film used was Kodak Ektaspeed(E group). All radiographs were evaluated by five dentist to recognize the true status of simulated carious lesion. They were asked to give a score of 0, 1, 2, or 3. Digitized images were obtained using a commercial video processor(FOTOVIX Ⅱ- XS). And the computer system was 486 DX PC with PC Vision and frame grabber. The 17' display monitor had a resolution of 1280×1024 pixels(0.26㎜ dot pitch). But the one frame of the intraoral radiograph has a resolution of 700×480 pixels and each pixel has a grey level value of 256. All the radiographs and digital images were viewed under uniform subdued lighting in the same reading room. After a week the second interpretation was performed in the same condition. The detection of lesions on the monitor was compared with the finding of simulated interproximal carious lesions on the film images. The results were as follows: 1. When the scoring criteria was dichotomous ; lesion present and not present 1) The overall sensitivity, specificity and diagnostic accuracy of periapical radiographs and their digital images showed no statistically significant difference. 2) The sensitivity and specificity according to the region of teeth and the grade of lesions showed no statistically significant difference between periapical radiographs and their digital images. 2. When estimate the grade of lesions ; score 0, 1, 2, 3 1) The overall diagnostic accuracy was 53.3% on the intraoral films and 52.9% on digital images. There was no significant difference. 2) The diagnostic accuracy according to the region of teeth showed no statistically significant difference between periapical radiographs and their digital images. 3. The degree of agreement and reliability 1) Using gamma value to show the degree of agreement, there was similarity between periapical films and digital images. 2) The reliability of each twice interpretation of periapical films and digital images showed no statistically significant difference. In all cases P value was greater than 0.05, showing that both techniques can be used to detect the incipient and moderate interproximal carious lesions with similar accuracy.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.680-687
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• 1996

Surgical removal of impacted mesiodens can be performed easily when exact position of mesiodens is identified. This case report is argued about methodological approach of exact antero-posterior postioning of mesiodens using conventional cross-sectional occlusal film and periapical film. The author concludes, 1. Among various methods of positioning mesiodens, exact position of mesiodens can be determined with occlusal film and periapical film. 2. On operation, exact antero-posterior position of mesiodens can be determined with comparing occlusal images of adjacent teeth and anatomic structure to real ones. 3. It is important that exact removal course of mesiodens has to be determined in addition to exact determination of one's position, and that it has to be determined in regard to position, morphological basis, direction of impacted pattern of mesiodens and adjacent anatomic structure. 4. In 2 cases presented, both are mesiodens of inverted conical type, and impacted direction are class I and III respectively according to classification author suggested, and surgery can be perfomed with ease by different approach directions.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.461-470
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• 1998

The comparative detectability of the artificial periapical defects among Ektaspeed Plus film. digitized and digora images was evaluated. The artifical defects were made in the cancellous bone and cancellous-cortical junction with the size of 1.0×0.8mm², 1.4×1.1mm² and 2.8×2.2mm². The defects in cancellous-cortical junction extended into cortical bone with the depth of 0, 0.5 and 1.0 mm. The results were as follows : 1. In junctional defects Ektaspeed Plus film for 2.8×12.2mm² defect showed the highest detectability. But significant difference were only found between Ektaspeed Plus films and digitized images (p<0.05). 2. Almost all defects within cacellous bone were not detected except a few digitized and Digora images for the size of 2.8×2.2mm². Digora images for them showed significant differences with Ektaspeed Plus films and digitized images (p<0.05). 3. The sensitinity of all imaging modalities were 0.9 or 1.0 in junctional defects for the size of 1.4×2.2mm² and 2.8×2.2mm². For cancellous defects, Digora image showed the highest sensitivity of 0.6 for the size of 2.8×2.2mm². 4. Significant differences for change of exposure time were found in most group of Ektaspeed Plus films and digitized images (p<0.05) . But there was no significant differences in Digora images for cacellous defects.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.1
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• pp.137-147
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• 1994

A digital imaging system using Machintosh Ⅱ ci computer, high resolution Sony XC-77 CCD camera, Quickcapture Frame Grabber Board was evaluated for quantitative analysis of standardized periapical film with aluminum step wedge. The results were as follows: 1. Correlation between Al thickness and gray level was high-positively associated(r²=0.99, p<0.001). 2. Correlation between measured weight of experimental lesion and estimated relative lesion volume by digital subtracted radiography was also high-positively associated (r²=0.98, p<0.001). 3. As exposure time was increased, mean gray level was decreased(p<0.01) and slope of regression line between Al thickness and gray level was also decreased (p<0.01). And when the exposure time was shorter than 0.2 second, the value of r² was relatively low. On the basis of the above results, it is considered that this digital imaging system using a Macintosh Ⅱ ci computer & a high resolution CCD monochrome camera will be useful in evaluating digitized image from standardized periapical film quantitatively.