Dental Faculty Accuracy When Using Diagnostic Codes: A Pilot Study.

The aim of this study was to examine the accuracy of dental faculty members' utilization of diagnostic codes and resulting treatment planning based on radiographic interproximal tooth radiolucencies. In 2015, 50 full-time and part-time general dentistry faculty members at one U.S. dental school were shown a sequence of 15 bitewing radiographs; one interproximal radiolucency was highlighted on each bitewing. For each radiographic lesion, participants were asked to choose the most appropriate diagnostic code (from a concise list of five codes, corresponding to lesion progression to outer/inner halves of enamel and outer/middle/pulpal thirds of dentin), acute treatment (attempt to arrest/remineralize non-invasively, operative intervention, or no treatment), and level of confidence in choices. Diagnostic and treatment choices of participants were compared to "gold standard" correct responses, as determined by expert radiology and operative faculty members, respectively. The majority of the participants selected the correct diagnostic code for lesions in the outer one-third of dentin (p<0.0001) and the pulpal one-third of dentin (p<0.0001). For lesions in the outer and inner halves of enamel and the middle one-third of dentin, the correct rates were moderate. However, the majority of the participants chose correct treatments on all types of lesions (correct rate 63.6-100%). Faculty members' confidence in their responses was generally high for all lesions, all above 90%. Diagnostic codes were appropriately assigned by participants for the very deepest lesions, but they were not assigned accurately for more incipient lesions (limited to enamel). Paradoxically, treatment choices were generally correct, regardless of diagnostic choices. Further calibration is needed to improve faculty use and teaching of diagnostic codes.

Comparison of technique errors of intraoral radiographs taken on film v photostimulable phosphor (PSP) plates.

OBJECTIVE: The objective of this study was to compare the technical errors of intraoral radiographs exposed on film v photostimulable phosphor (PSP) plates. METHODS: The intraoral radiographic images exposed on phantoms from preclinical practical exams of dental and dental hygiene students were used. Each exam consisted of 10 designated periapical and bitewing views. A total of 107 film sets and 122 PSP sets were evaluated for technique errors, including placement, elongation, foreshortening, overlapping, cone cut, receptor bending, density, mounting, dot in apical area, and others. Some errors were further subcategorized as minor, major, or remake depending on the severity. The percentages of radiographs with various errors were compared between film and PSP by the Fisher's Exact Test. RESULTS: Compared with film, there was significantly less PSP foreshortening, elongation, and bending errors, but significantly more placement and overlapping errors. Using a wrong sized receptor due to the similarity of the color of the package sleeves is a unique PSP error. CONCLUSIONS: Optimum image quality is attainable with PSP plates as well as film. When switching from film to a PSP digital environment, more emphasis is necessary for placing the PSP plates, especially those with excessive packet edge, and then correcting the corresponding angulation for the beam alignment. Better design for improving intraoral visibility and easy identification of different sized PSP will improve the clinician's technical performance with this receptor.