Diagnostic accuracy of conventional versus digital radiography in detection of external root resorption

External root resorption is a clinical problem that often is difficult to detect. Since external root resorption is not detectable clinically, radiographic examination is very important. The objective of this study was to compare diagnostic efficacy of conventional film versus direct digital radiography in detecting simulated root resorptive cavities in vitro. This study was based on observational diagnostic methods. A total of 39 extracted teeth including 10 anterior teeth, 6 canines, 8 premolars, 5 maxillary molars and 10 mandibular molars were selected. Except palatal root of upper molars, each root was divided to apical and coronal halves. Half of these sites were considered as control. Buccal cavities were randomly prepared in the remaining sites by # 1/2, #2, and #4 round burs. Each tooth was imaged twice using a CCD based digital system and an E speed film. Radiographs were taken with 0 And 20 degrees mesial angulation .Six image groups were interpreted by 2 experienced oral and maxillofacial radiologists and one endodontist. Conventional radiographs were observed at 2X magnification by a magnifying glass. Sensitivity, speciflcity, false negative and false positive percentage and also accuracy on each method were analyzed in comparison with golden standard. Agreement among these techniques was expressed as the kappa score. Results: The most sensitive technique was conventional radiography at 2X magnification .Sensitivity of digital radiography and enhanced digital radiography were almost equivalent. The most specific technique was also conventional radiography at 2X magnification followed by enhanced digital radiography. Among all, the highest diagnostic accuracy was in conventional radiography at 2X magnification followed by enhanced digital radiography. Taking images with mesial angulation increased sensitivity and decreased speciflcity in all techniques. Therefore, it did not influence the diagnostic accuracy of conventional and enhanced digital radiography. There was an increased agreement between digital radiographic techniques and digital imaging with enhancement options.[k=0.68]. In detecting external root resorption, diagnostic efficacy of conventional radiography at 2X magnification was more than those in enhanced and unenhanced digital radiograph

Abnormal temporomandibular joint radiographic findings in patients referred to department of oral and maxillofacial radiology, dental school, Shahid Beheshti University of Medical Sciences

Temporomandibular Joint disorders are relatively frequent in different societies. The purpose of the present study was to determine abnormal Temporomandibular Joint radiographic findings in patients referred to Dental School, Shahid Beheshti University. This descriptive cross-sectional study was done on 400 patients with no marked symptoms of temporomandibular joint disorders who met criteria of the study. Mean age of patient was 38.38. The data was collected by taking patients history, clinical evaluation while the panoramic radiographies were taken in standard conditions viewing by means of black-colored sheets .for statistical evaluation data was analyzed by chi- square and exact fisher tests. Flattening was the most observed abnormal finding with 16.3% incidence. Erosion, condylar hyperplasia, concavity, Bifid condyle,condylar hypoplasia and sclerosis respected were the most common abnormal findings in this study. There were no significant differences in the incidence of abnormal findings regarding the patient's gender, dental status and occlusion, but the prevalence of abnormal radiographic findings was significantly uprising as the age of the patients increased [P< 0.002]. The results demonstrated the incidence of abnormal radiographic findings in 34.4% of the patients referring to the studied center which shows a relatively high prevalence

ability of panoramic radiography in determining the relationship of mandibular third molar roots with the inferior alveolar canal

Panoramic radiography is the preoperative imaging technique of choice for impacted mandibular third molar surgery. However, controversy exists regarding the ability of panoramic radiography in determining the relationship of the mandibular third molar roots with the inferior alveolar canal. This study aimed to assess the ability of panoramic radiography in determining the relationship of mandibular third molar roots with the inferior alveolar nerve [IAN] canal. This diagnostic accuracy study was conducted on 100 panoramic radiographs that were evaluated by 5 oral and maxillofacial surgery residents. They offered their expert opinion on the relationship of third molars with the IAN canal based on panoramic radiographs. These perspectives were compared with the actual post-surgical findings. Kappa and weighted Kappa reproducibility tests were used for data analysis. Among 100 understudy cases, physical contactbetween the mandibular third molar roots and the canal was not observed in 88 cases intra-operatively; while this relationship existed in 12 cases. The panoramic radiography had a diagnostic sensitivity of 83.3%, specificity of 83%, positive predictive value of 40% and negative predictive value of 97.3%. The overall accuracy was 85%. Kappa and weighted Kappa coefficients of reproducibility were 61% and 79%, respectively. Panoramic radiography can be confidently used as the most reliable and commonly accessible imaging technique. Considering the obtained negative predictive value, panoramic radiography is capable of revealing the involvement of third molar roots with the IAN canal with 97.3% accuracy. Panoramic radiography had a low diagnostic value in determining the morphology of roots

consistency of panoramic radiography selection criteria by dentists in Tehran with the FDA guidelines

Use of panoramic radiography in some cases is easier and more cost-effective than other radiographies. However, it has some limitations as well. Considering the importance of radiography in dentistry, the present study sought to assess the consistency of selection of panoramic radiography by general dentists in Tehranwith FDA guidelines during 2010-2011. In this descriptive cross-sectional study, 500 general dentists were selected using randomized cluster sampling and evaluated by a questionnaire. The questionnaire asked for demographic data and had 27 questions regarding the selection criteria for panoramic radiography. Dentists had the following answer choices for each criterion: [Strongly leads to prescription], [probably leads to prescription], [has no effect on prescription], [probably prevents prescription] and [strongly prevents prescription]. The answers were collected and descriptively analyzed. To evaluate the effect of different factors on dentists' answers, binary logistic regression with enter method was used. Of the understudy dentists, 44% were females and 56% were males with a mean age of 36.84 yrs. Based on the results of regression analysis, panoramic radiography was prescribed by dentists in case of concerns regarding the carcinogenicity of radiation, good oral hygiene and for evaluation of growth and development before the age of 6 which are not in accord with the FDA guidelines. Also, for primary assessment of periodontal status, poor oral hygiene, disseminated pain, determination of alveolar crest height in the anterior region and pregnancy, panoramic radiography was prescribed by dentists which is completely in agreement with the FDA guidelines [P<0.05]. Easy application of panoramic radiography and its accessibility were the reasons for its prescription in 55.5% and 47.6% of cases, respectively. Some reasons of prescription were in accord with the FDA guidelines while some others were in contrast to them

Diffuse infiltrating retinoblastoma simulating endophthalmitis: a case report / 国际眼科杂志(Guoji Yanke Zazhi)

·Diffusely infiltrating retinoblastoma is a rare histopatho-logic type of retinoblastoma, accounting for approximate-ly 1% to 2% of retinoblastoma cases. We report a case of diffuse infiltrating retinoblastoma presenting as endo-phthalmitis and comment on the histopathologic findings.