Comparison of Accuracy Between Pulp/Tooth Ratio and Tooth Coronal Index Methods for Dental Age Estimation Using Digital Panoramic Radiographs

ABSTRACT Objective: To evaluate the reliability and the accuracy of Tooth Coronal Index (TCI) and Pulp/Tooth Ratio (PTR) methods in dental age estimation using digital panoramic radiography. Material and Methods: In this cross-sectional study, 237 dental panoramic images were collected. The two methods (TCI and PTR) were applied to all left mandibular first and second molars based on inclusion and exclusion criteria. In order to analyze the acquired data, statistical methods were used. The estimated ages derived by exclusive formula were compared to the chronological age, and the error ranges for each indicator were measured to determine their accuracy. Results: There were negative correlations between PTR in the first molar (r=-0.89) and in the second molar (r=-0.788), as well as TCI in the first molar (r=-0.587) and in the second molar (r=-.242). In this study, we found that the Pulp/Tooth Ratio (PTR) accuracy rate for mandibular first and second molar teeth was 79.21% and 62.09 %, respectively, although the Tooth Coronal Index (TCI) value for these teeth was 34.45% and 5.85%. Conclusion: Pulp/Tooth Ratio and Tooth Coronal Index are potential age estimation indices. Although PTR was the more accurate one in our study. The results also demonstrated that indices related to the first molar tooth could be used to estimate age with greater accuracy and validity.

Comparison of skeletal changes related to patients with chronic kidney disease and healthy individuals in digital panoramic radiography

Background: Chronic kidney disease (CKD) is a prevalent condition affecting bone metabolism. Bone changes in CKD patients also known as renal osteodystrophy happen due to disorders in the regulation of water and electrolytes caused by the disease. The aim of this study is to investigate the bone changes of CKD stages 3–5 patients without dialysis using digital panoramic radiography. Materials and Methods: In this cross-sectional study, panoramic radiographs were obtained from 30 patients with CKD stages 3–5 and 30 age and gender matched healthy individuals. The mean values of quantitative parameters such as mental index (MI), panoramic mandibular index (PMI), and antegonial index (AI) were measured and qualitative parameters such as mandibular cortical index (MCI) and trabecular bone pattern (TP) were recorded based on Kelemetti and Lindh calcifications, respectively. Statistical analysis was performed using t-test, Chi-square, and Mann–Whitney test (α = 0.05). Results: The mean values of MI, PMI, and AI in the two groups were not statistically significant (P > 0.05). MCI and TP were significantly different between the two groups. MCI showed more defects in mandibular cortex of CKD patients (6.7% of patients vs. 0% of control group were C3, P = 0.038), and TP showed more porosity in mandibular bone of CKD patients (10% of patients vs. 0% of control group were sparse, P = 0.001). Conclusion: The amount of MI, PMI, and AI were not related to CKD. While MCI and TP were significant parameters that showed mandibular cortical situation and trabecular bone pattern, they assess osteoporosis level in a more reliable manner in CKD stages 3–5 patients without dialysis.

Effect of Different Exposure Conditions and Developing Solution Concentration on the Clarity of Cervical Burnout in Bitewing Radiographs.

Aims: Exposure and developing conditions can affect the occurrence of cervical burnout in bitewing radiographs which is one of the common false positive errors in these images. This study was designed to evaluate the effect of kilo voltage peak (KVP), milliampere second (mAS) and concentration of developing solution on clarity of cervical burnout in bitewing radiographs. Study Design: It was an experimental study performed on phantom head. Place and Duration of Study: Department of Oral and Maxillofacial Radiology, Isfahan University of Medical Sciences in Isfahan, between August 2012 and June 2013. Methodology: Seven bitewing radiographs were taken by XCP film holder from phantom premolars with different exposure conditions and same intensity. Then films were processed using processing solution with optimum concentration. Radiographic procedures were repeated twice under the same exposure conditions. In the first case, the films were processed by half of optimum concentration of developing solution. In the second case, the films were processed by the condition twice as concentrated as the optimum developing solution. Two oral and maxillofacial radiologists evaluated the clarity of cervical burnout. Data were analyzed using Kruskal-Wallis, Mann–Whitney U and Spearman’s correlation test by SPSS software (Version 11.5). Results: This study revealed a significant effect of exposure conditions on clarity of cervical burnout (p<0.05) but there wasn’t any significant difference among tested concentrations of developing solution. Moreover, exposure conditions and cervical burnout clarity were significantly correlated. (p<0.05). Conclusion: The use of lower contrast radiographs (high KVP and low mAs) can be useful for detecting proximal caries and preventing false positive errors like cervical burnout.