[ effect of developer age the diagnostic accuracy of endodontic files' length]

Radiography has extensive applications in root canal treatment and the developer age plays an important role in making a definite diagnosis. The present study examined the effect of developer age on the diagnostic accuracy of endodontic file length measurement using D-speed, E-speed and E/F-speed films. In this diagnostic study, radiographs were processed weekly by a developer aged for up to 6 weeks. Radiographs were viewed by 5 postgraduate students of endodontics and oral radiology. They determined the file tip position using a 3-point confidence scale. The area under the curve [Az] was calculated and used as a diagnostic accuracy scale. The effects of film type and endodontic file size were analyzed by one-way ANOVA, Tukey's post hoc test and Student's t test. E-speed and D-speed films had similar diagnostic accuracy higher than that of E/F speed film [P<0.0001]. The Az values of D, E and E/F speed films were 0.5882, 0.5538 and 0.3578, in fresh developer, 0.5782, 0.5718 and 0.3498 in 2-week old developer and 0.6196, 0.6724 and 0.2080, in 4-week old developer solution, respectively. Developer age did not decrease the diagnostic accuracy of D and E-speed films but decreased that of E/F films at 4 weeks. Radiographs processed with 6 weeks old developer were not readable. All observers showed higher diagnostic accuracy determining the size of file # 15 than 10 [P<0.0001]. The mean Az values for endodontic file sizes 10 and 15 using fresh, 2-week and 4-week old developers were 0.3984 and 0.6016, 0.3732, and 0.6268 and 0.2774 and 0.7226, respectively. The developer aged for up to 4 weeks did not significantly affect the diag-nostic accuracy of D-speed and E-speed films. E/F speed films cannot be used with de-velopers older than 2 weeks and their usage was associated with lower accuracy compared to E and D-speed films

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

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

[Comparison of alexithymia, anxiety, depression and digestive symptoms between patients with functional gastrointestinal disorders and psychiatric patients]

The purpose of this study was to compare alexithymia, anxiety, depression and severity of gastrointestinal symptoms in patients with functional gastrointestinal disorders and psychiatric patients. This was a comparative study. Study subjects consisted of 210 individuals; 129 patients with functional gastrointestinal disorders [FGID] who referred to the Psychosomatic Disorders Clinic [GI] and 81 psychiatric patients who referred to the Mood Disorders Clinic of Noor Hospital, Isfahan, Iran during 1387 [2008]. Subjects' symptoms were scored according to the Toronto Alexithymia Scale [TAS-20], Hospital Anxiety and Depression Scale [HADS] and Gastrointestinal Symptoms Rating Scale [GSRS]. Data were analyzed using multivariate analysis of variance. The results showed significant differences between two group of FGID and psychiatric patients in terms of alexithymia, anxiety, depression and severity of gastrointestinal symptoms. The study showed that in comparison to psychiatric patients, FGID patients have higher rates of alexithymia, anxiety, depression and more severe gastrointestinal symptoms. Alexithymia plays an important role in understanding symptoms and referrals to doctor's offices. Regardless of which treatment is selected by the patients, a high proportion experience concurrent psychiatric and functional somatic symptoms. Therefore, evaluation and attention to this factor is necessary for the treatment of psychosomatic disorders