Knowledge, Attitude, and Practice, about Digital and Conventional Radiographs among General Dentists and Specialists in Kanchipuram District

Radiographs are an important tool in maximizing oral health care. During initial years, the film based radiographic images were used, as technological advancements progressed, digital radiographic imaging has become an indispensable tool in diagnosis. The aim of the present study is to evaluate the practice of digital and conventional radiographs, and radiation safety among dental practitioners. METHODSA questionnaire descriptive study was conducted, including general dental practitioners and dental specialists in Kanchipuram district. The questionnaire comprised of 12 questions that were distributed through Google forms, email and responses were collected. The questions were based on their preference about digital or conventional radiographs, reason for their preference, satisfaction with diagnostic quality, patient compliance, and their radiation protection practice. RESULTSA total of 200 dental practitioners in Kanchipuram district was given questionnaires. All of them answered the questionnaire. 148 were males and 52 were females. The age distribution was between 26 - 33 years. 65 % of the practitioners answered that they use digital radiographs often owing to less time consumption and ease of storage, 90 % of them answered that their diagnostic quality is improved by using digital radiographs, of which 51 % use radiation protection and 39 % of their patients use radiation protection during exposure. CONCLUSIONSThis era is moving towards digital radiography, among the ones who are using it, most of them are satisfied with it. Attitude towards radiation protection and hazards has to be improved amongst dental practitioners. The use of digital radiography is increasing among dental practitioners due to its less radiation exposure, improved diagnostic quality, ease of access and as it is less time consuming. The need for availability of standard improved quality of care equally raises the point for cost effective methods for the developing technologies.

MRI on rotator cuff and shoulder joint pathologies

The shoulder joint is an elegant anatomic structure formed by the humerus, clavicle and the scapula; its range of motion exceeds all other joints, yet under most circumstances, it is stable. The shoulder complex comprises of three joints namely the sternoclavicular, acromioclavicular, and glenohumeral joints. The factors which aid on to this progress including age, occupation, trauma, acromion type, slope and position, acromioclavicular joint degeneration, proximal migration of the humeral head, bony spurs compressing on the tendons. The most commonly affected rotator cuff tendon being the supraspinatus. The tears are further classified as complete/full thickness and partial tears depending on the involvement of the whole or part of the tendon. Being one of the most important stabiliser of the shoulder joint, rotator cuff pathologies can cause major joint dysfunction, like stiffness, restricted/painful joint movements even to the extent of restricting daily activities our study aims to describe MRI characteristics of shoulder and rotator cuff pathologies. And to describe the distribution of rotator cuff pathologies in terms of age, gender, symptomatology and secondary changes/sequelae study, the rotator cuff abnormalities were common in the sixth and seventh decades of life. The incidence of predisposing factors for rotator cuff tears was also found to increase with age as seen in our study, type II and III acromions, acromioclavicular joint arthropathies, osteophytosis/spurs are common in the sixth and seventh decades of life. We noticed in our patients that pain followed by stiffness resulting in reduced range of movement across the shoulder joint is very common. MRI imaging was useful in effectively ruling out the other causes of shoulder pain, overall features conclude that magnetic resonance imaging is very useful in depicting rotator cuff disease diagnosis along with the predisposing factors like the acromion type and orientation, reduction in coracohumeral distance, reduced acromioclavicular distance and other associated features like effusion, bursitis and bone changes. Further research with a larger sample size for a longer study period is suggested to draw broader conclusions and to strengthen the findings of the present study.

Descripción radiográfica de postes de titanio y de fibra de vidrio, cementados en premolares humanos sometidos in vitro a altas temperaturas con fines forenses / Radiographic description of titanium and fiberglass posts cemented in human premolars subjected to high temperatures in vitro for forensic purposes

Introducción: durante el proceso de identificación forense de cadáveres y restos humanos quemados, carbonizados o incinerados, el análisis de los materiales empleados en los diferentes tratamientos odontológicos se constituye en un marcador fehaciente para lograr una identificación positiva. El objetivo de este trabajo fue describir los cambios radiográficos de postes de titanio y de fibra de vidrio cementados, en premolares humanos sometidos a altas temperaturas con fines forenses. Métodos: estudio pseudo-experimental in vitro que observó los cambios radiográficos de los tejidos dentales (esmalte, dentina y cemento), de los materiales de uso endodóncico gutapercha (Wave One® de Dentsply Maillefer®), material de obturación (Top Seal® de Dentsply Maillefer®), material de cementación de los postes (Relyx TM ARC de 3M ESPE®) y de los postes de titanio (Tenax® Endodontic Post System de Coltene®) y fibra de vidrio (Tenax® Fiber Trans de Coltene®) en 30 dientes humanos, sometidos a cinco rangos de temperatura 200, 400, 600, 800 y 1000ºC. Resultados: los tejidos y los materiales dentales estudiados presentan gran resistencia a las altas temperaturas, sin variar considerablemente su macro-estructura (fisuras, grietas, fracturas y fragmentación), de tal manera que los cambios físicos pueden identificarse a través de radiografía convencional, y asociarse a cada rango de temperatura específico. Conclusiones: los postes cementados en premolares humanos presentan gran resistencia a la acción de altas temperaturas, razón por la cual pueden ser visualizados a través de radiografía convencional, contribuyendo con el proceso de identificación y documentación de la necropsia médico-legal de un cadáver o restos humanos que hayan resultado quemados, incinerados o carbonizados

IIntroduction: during the process of forensic identification of corpses and burnt, carbonized, or incinerated human remains, the analysis of materials used in dental treatments is a reliable marker for accurate identification. The objective of this study was to describe the radiographic changes of titanium and fiberglass posts cemented in human premolars subjected to high temperatures for forensic purposes. Methods: this was a pseudo-experimental in vitro study to observe the radiographic changes of dental tissues (enamel, dentin, and cement) and the following endodontic materials: gutta-percha (Wave One® by Dentsply Maillefer®), obturation material (Top Seal® by Dentsply Maillefer®), post cementation material (Relyx TM ARC by 3M ESPE®), titanium posts (Tenax® Endodontic Post System by Coltene®), and fiberglass posts (Tenax® Fiber Trans by Coltene®) in 30 human teeth subject to five temperature ranges: 200, 400, 600, 800, and 1000° C. Results: the studied dental tissues and materials are highly resistant to high temperatures without significantly changing their macrostructure (fissures, cracks, fractures, and fragmentation), in such a way that the physical changes can be identified through conventional radiography and associated with each specific temperature range. Conclusions: posts cemented in human premolars have great resistance to the action of high temperatures, so they can be observed through conventional radiography thus contributing to the process of identification and documentation of the medico-legal autopsy of a corpse or human remains that have been burned, incinerated, or carbonized

A comparative study of the conventional and digital intraoral radiography methods for root canal length measurement / Comparação entre Radiografia intraoral convencional e digital para medição de comprimento do canal radicular: estudo in vitro

Objective: Measurement of root canal length is one of the most important stages of endodentic treatment, and any error at this stage can lead to the failure. This study aimed to compare conventional and digital intraoral radiography in measurement of root canal length. Material and Methods: In this study, 35 single-canal maxillary teeth were collected. Access cavities were prepared. An endodontic number 10#K- file was introduced into the canal, until the tip was visible at the apical foramen and the actual canal length (gold standard) was determined. After acquisition conventional radiographs using E-Ektaspeed and F-Insight film (Eastman-Kodak Co. Rochester, NY, USA) and digital radiographs using Photostimulable Phosphor Plates(PSP) (Soredex, Helsinki, Finland) and Charge Coupled Devices (CCD)(RVG, Trophy,NY,USA). they were examined separately with a two-week interval by two oral and maxillofacial radiologists. The data were analyzed with ANOVA and Tukey’s tests using SPSS-19 software (SPSS Inc., Chicago, IL, USA). Result: No statistically significant difference was observed between different radiographies, and different observers (P > 0.05). Nevertheless, in comparison with the gold standard, in all cases, the F-speed conventional radiography and the digital CCD radiography showed the highest and the lowest accuracy, respectively. Also, the PSP and the E-speed conventional radiography were in the second and third order of accuracy, respectively. Conclusion: The use of digital radiography does not improve the accuracy of the root canal length measurement,but the digital technique has advantages,such as the reduced patient exposure, eliminating the time consuming processing stages, and producing fast images...

Objetivo: A medição do comprimento do canal radicular é uma das etapas mais importantes de tratamento endodôntico, e qualquer erro nesta fase pode levar ao fracasso. Este estudo teve como objetivo comparar a radiografia intra-oral convencional e digital na medida do comprimento do canal radicular.Material e Métodos: Neste estudo, 35 dentes superiores com canal único foram coletados. Cavidades de acesso foram preparadas. Uma lima endodôntica tipo K, número 10 foi introduzida no canal, até que a ponta era visível no forame apical e o comprimento do canal real (padrão ouro) foi determinada. Após a aquisição de radiografias convencionais, utilizando os filmes E-Ektaspeed e F- Insight (Eastman Kodak Co.,Rochester, NY, EUA) e radiografias digitais utilizando placas foto estimuláveis de fósforo (PSP) (Soredex, Helsinki, Finlândia) e dispositivos de acoplamento (CCD) (RVG, Troféu, NY, EUA), as mesmas foram examinadas separadamente com um intervalo de duas semanas, por dois radiologistas oral maxilofaciais. Os dados foram analisados pelos Testes de ANOVA e Tukey utilizando o software SPSS-19 (SPSS Inc., Chicago, IL, EUA). Resultados: Não houve diferença estatisticamente significativa entre as diferentes radiografias, e observadores diferentes (P > 0,05). No entanto, em comparação com o padrão-ouro, em todos os casos, a radiografia convencional e a radiografia digital CCD apresentaram o maior e a menor precisão, respectivamente. Além disso, a PSP e a radiografia convencional estavam na segunda e terceira ordem de precisão, respectivamente. Conclusão: O uso da radiografia digital não melhora a precisão da medição do comprimento de canal, mas a técnica digital tem vantagens, tais como a exposição do paciente reduzida, eliminando o demorado estágio de processamento, produzindo assim, imagens mais rápidas...

A comparison between conventional and digital radiography in root canal working length determination.

Aim and Objectives: Obtaining a correct working length is necessary for successful root canal treatment. The aim of this study was to compare conventional and digital radiography in measuring root canal working length. Materials and Methods: In this in vitro study 20 mesio buccal canal from maxillary first molars with moderate and severe curvature and 20 canal form anterior teeth with mild curvature were chosen and their working length were measured with number 15 k file (Maillefer, DENTSPLY, Germany). Then for each canal five radiographies were taken, three conventional radiographies using three methods of processing: Manual, automatic, and monobath solution; in addition to two other digital radiographies using CCD and PSP receptors. Two independent observers measured working length in each technique. Finally, the mean of working length in each group was compared with real working length using a paired T-test. Also a one-way ANOVA test was used for comparing the two groups. The level of statistical significance was P < 0.05. Results: The results have shown that there was a high interobserver agreement on the measurements of the working length in conventional and digital radiography (P≤0.001). Also there was no significant difference between conventional and digital radiography in measuring working length (P > 0.05). Conclusion: Therefore it was concluded that the accuracy of digital radiography is comparable with conventional radiography in measuring working length, so considering the advantages of the digital radiography, it can be used for working length determination.

Diagnóstico por imagem da artrite reumatoide inicial / Imaging diagnosis of early rheumatoid arthritis

O diagnóstico precoce da artrite reumatoide é essencial para o manejo adequado da condição. Atualmente, considera-se que a fase inicial da doença constitui uma janela de oportunidade terapêutica para a artrite reumatoide. Embora o diagnóstico seja primordialmente clínico, o desenvolvimento e o aprimoramento de métodos laboratoriais e de imagem têm contribuído para o diagnóstico mais precoce e a determinação da conduta na artrite reumatoide inicial. Neste artigo os autores revisam o papel dos principais métodos de imagem utilizados para a avaliação da artrite reumatoide inicial, notadamente a radiologia convencional, a ultrassonografia e a ressonância magnética.

Early diagnosis of rheumatoid arthritis is essential for its proper management. Currently, the initial phase of rheumatoid arthritis is known to provide a window of therapeutic opportunity. Although the diagnosis is primarily clinical, the development and improvement of laboratory and imaging methods have contributed to earlier diagnosis and determination of procedures in early rheumatoid arthritis. In this article, the authors review the role of the major imaging methods used for assessing early rheumatoid arthritis, especially conventional radiography, ultrasonography, and magnetic resonance imaging.

Cone beam computed tomography in endodontics

Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillo-facial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontics. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice.

Tomografia computadorizada de feixe cônico (CBCT, sigla em Inglês para cone beam computed tomography) é um moderno sistema radiológico de imagem idealizado especificamente para uso no esqueleto maxilofacial. Este sistema supera muitas das limitações da radiografia convencional, produzindo imagens não distorcidas e tridimensionais da área examinada. Tais propriedades tornam este método de imagem especialmente apropriado para a Endodontia. O profissional consegue obter uma visão melhor da região anatômica desejada, resultando em melhor detecção de doenças de origem endodôntica e um planejamento mais efetivo do tratamento. Além disso, o sistema utiliza doses de radiação significantemente menores em comparação à tomografia computadorizada convencional. O objetivo deste artigo é revisar a literatura atual relativa às limitações e possíveis aplicações da CBCT na prática endodôntica.

Avaliação qualitativa entre as radiografias cefalométricas laterais digital e convencional / Qualitative evaluation between conventional and digital lateral cephalograms

OBJETIVOS: avaliar, por meio do traçado cefalométrico e medidas cefalométricas, a dificuldade na localização das estruturas e dos pontos, tanto na radiografia convencional quanto na digital. METODOLOGIA: a amostra constituiu-se de 30 telerradiografias em norma lateral, sendo 15 convencionais e 15 digitais. Essas radiografias foram obtidas de 15 indivíduos brasileiros, adultos, sendo que de cada paciente obteve-se uma radiografia convencional e uma digital. RESULTADOS: com base nos dados obtidos, observou-se que não houve diferença estatisticamente significativa quando comparados os dois métodos de estudo. CONCLUSÕES: sendo assim, concluiu-se que, independentemente do método aplicado, o indivíduo que realiza o traçado, seja manual ou por meio de programas de computador, tanto na radiografia convencional quanto na digital, deve estar treinado e calibrado para a execução do mesmo.

AIM: This study aimed to evaluate, by cephalometric tracing and measurements, the difficulty in the localization of structures and points on both conventional and digital lateral cephalograms. METHODS: The sample comprised 30 lateral cephalograms, being 15 conventional and 15 digital. These radiographs were taken from 15 Brazilian adult subjects, with achievement of one conventional and one digital cephalogram for each subject. RESULTS: The obtained data revealed no statistically significant difference between the two study methods. CONCLUSION: Thus, it was concluded that, regardless of the utilized method, the professional performing the cephalometric tracing, either manually or with a computer software, should be well trained and calibrated for that.

Abdome agudo obstrutivo: revisando pontos fundamentais / Obstructive acute abdomen: reviewing important points

O abdome agudo obstrutivo é uma doença comum, cujo manejo seguro e efetivo depende do diagnóstico rápido e preciso. A radiografia simples permanece a primeira escolha dentre os exames de imagem, por possuir fácil acesso, baixo custo e poder ser realizada seriada conforme a evoluçãoclínica do paciente. A ultra-sonografia não possui radiação ionizante, é um exame dinâmico e em tempo real. A tomografia computadorizada fornece informações adicionais não aparentes nas radiografias, como confirmação da obstrução, grau e local de uma oclusão, presença de isquemia e causas de obstrução. A ressonância magnética tem apresentado grandes avanços tecnológicos e, futuramente, pode ser uma opção viável. O objetivo deste ensaio pictórico é revisar os diferentes métodos de imagem usados no diagnóstico de abdome agudo obstrutivo.

The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost andthe possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomographyis used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presenceof ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen.

Plane-parallel ionization chamber for X-radiation of conventional radiography and mammography / Câmara de ionização de placas paralelas para radiação-X de radiografia convencional e mamografia

OBJETIVO: Desenvolver uma câmara de ionização de placas paralelas de dupla face para determinação de kerma no ar e taxa de kerma no ar em campos de radiação-X utilizados em radiografia convencional e mamografia. MATERIAIS E MÉTODOS: A câmara desenvolvida tem janelas de entrada de poliéster aluminizado, elétrodos internos e anéis de guarda de alumínio em uma face (face A) e de grafite na outra (face G). Neste trabalho foram testadas as características operacionais de linearidade, dependência angular e energética de resposta. RESULTADOS: A linearidade de resposta foi de 0,86 por cento para a face A e de 0,92 por cento para a face G. Para ângulos de incidência da radiação de 0º a ± 5º, a variação da resposta relativa foi menor que 0,8 por cento para ambas as faces da câmara. A dependência energética de resposta foi de 0,8 por cento para a face A nas qualidades de raios-X para diagnóstico convencional e de 2,4 por cento para a face G da câmara nas qualidades de raios-X para mamografia. CONCLUSÃO: Esta câmara pode ser utilizada rotineiramente na determinação de kerma no ar e taxa de kerma no ar em feixes de raios-X utilizados em radiografia convencional e mamografia.

OBJECTIVE: To develop a double-faced plane-parallel ionization chamber for measurement of air kerma and air kerma rate in X-radiation fields utilized in conventional radiography and mammography. MATERIALS AND METHODS: The chamber has entrance windows made of aluminized polyester film, inner and guard electrodes of aluminum at one side (face A) and graphite at the other side (face G). The present study evaluated operational characteristics as regards response linearity, angular and energy dependence. RESULTS: The linearity of response was 0.86 percent for face A and 0.92 percent for face G. For radiation incidence angles, of 0º to ± 5º, the response variation was less than 0.8 percent for both faces of the chamber. The energy dependence of response was 0.8 percent for face A on X-ray qualities for conventional radiography, and 2.4 percent for the face G of the chamber on X-ray qualities for mammography. CONCLUSION: This chamber can be utilized on a routine basis for measurement of air kerma and air kerma rate in X-ray beams utilized in conventional radiography and mammography.

The Clinical Value of Computerized Tomography in the Evaluation of Pelvic Bone Fractures / 대한정형외과학회잡지

The clinical value of CT in the diagnosis of pelvic bone fractures is being explored. Conventional radiographic projections, including internal and external oblique views, although very helpful, often cannot provide sufficent jnformation to give a true sense of the fractures. CT conversely displays the anatomy in an axial plane, thereby providing the missing pieces of information and fascilitating classification of these fractures. From January 1983 to June 1986, 34 patients with pelvic bone fractures, admitted to Department of Orthopedic Surgery, Severance Hospital, were given both CT and conventional radiographs. Comparing the conventional radiographic findings with those of CT, the following conclusions were obtained. 1. For patients with multiple trauma who necessitate position changes during conventional radiography, no further change in position was required during CT. 2. CT clearly showed intraarticular loose bodies, anterior wall fractures of the acetabulum, and separations of the saicroiliac joint which were hardly detected on conventional radiographs. 3. CT permitted a better evaluation of the shape, extent, and degree of separation of fracture fragment, so it was very helpful in formulating the treatment plan. 4. Follow-up CT was helpful in evaluating the effectiveness of treatment.