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Introduction: Odontogenic infection leads to increased thickness of maxillary sinus membrane. This is aided by close relationship between the roots of upper posterior teeth and floor of the maxillary sinus. This can be viewed by using imaging modalities. Aim: The review has been conducted to compare CBCT (Cone Beam Computed Tomography) with Orthopantomogram (OPG) in detecting maxillary sinus membrane thickening in patients with odontogenic anomaly through a meta-analysis. Materials and Methods: The review was carried out by following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered as PROSPERO 2023 CRD42023390257. PubMed, Google Scholar and EBSCO host were queried for literature published from January 2000 to December 2022. Newcastle Ottawa scale evaluated the quality of articles. Results: Statistical analysis was performed and forest plot was plotted using RevMan (Review Manager) software version 5.3. Five studies were eligible and two of them were suitable for Meta-Analysis. The Standardized Mean Difference yielded a pooled estimate of 0.39 and preferred CBCT using a random effect model with a P value of 0.02 and an I2 (heterogeneity) value of 59%. Funnel plot showed absence of publication bias. Conclusion: It was concluded that CBCT was effective, as compared to OPG in detecting maxillary sinus membrane thickening with odontogenic anomaly.

Introduction: Digital radiography seems necessary for overcoming educational problems and archiving radiographs taken from patients; nonetheless, the views of students and professors about this issue have been less studied. Therefore, the present study aimed to investigate the satisfaction of professors and students with the use of conventional and digital radiography in the Endodontics Department of Mashhad Dental School.Materials and Methods: This study was conducted on the professors of the Department of Root Therapy and 155 Dental Students in Mashhad. The research tool consisted of two researcher-made questionnaires. The first questionnaire was about the quality of the root therapy that was completed by the professors. The second questionnaire was about students' satisfaction with the use of digital and conventional radiography in the endodontics section. The information was recorded, and the data were then compared using Chi-square and Fisher tests.Results: The findings of this study demonstrated that from professors' point of view, digital imaging in dentistry had better quality, shorter time, and less error, and professors' satisfaction was significantly higher. Moreover, students had a more positive opinion of digital imaging in terms of quality, less time, less error, and less student congestion. Finally, students were more satisfied with digital imaging (P=0.05).Conclusion: As evidenced by the obtained results, it can be concluded that digital radiography improved the education and satisfaction of both groups of students and professors.

ObjectivesTo identify the prevalence of calcium pyrophosphate crystal deposition (CPPD) using ultrasound and conventional radiology at peripheral joints in patients with suspected or definite CPPD.MethodsA systematic literature search was performed in PubMed and Embase using pre-defined search strategies from inception to April 2021 to identify studies that evaluated conventional radiology and ultrasound in detecting CPPD at peripheral joints, including definite or suspected CPPD [Research question 1 (RQ1) and Research Question 2 (RQ2), respectively]. For the meta-analysis, the first, second, and third sub-analysis included studies with the knee, and knee or wrist as the index joint for CPPD (without restrictions on the reference standard) and synovial fluid analysis or histology as a reference standard (without restrictions on the index joint), respectively.ResultsOne-thousand eight hundred and twenty-seven manuscripts were identified, of which 94 articles were finally included. Twenty-two and seventy-two papers were included in RQ1 and RQ2, respectively. The knee had the highest prevalence for RQ1 and RQ2 by both conventional radiology and ultrasound, followed by the wrist with the highest prevalence for RQ1. The hand had the lowest CPPD prevalence. The third sub-analysis showed a higher CPPD prevalence on ultrasound than conventional radiology at the knee (only data available).ConclusionAmong all peripheral joints, the knees and wrists could be regarded as the target joints for CPPD detection by imaging. Furthermore, ultrasound seems to detect a higher number of calcium pyrophosphate deposits than conventional radiology, even when using a more restrictive reference standard.

X-rays are electromagnetic waves produced by an X-ray machine and are used to observe the internal structures of patients. The X-rays pass through the body before being detected by the detector file or a digital detector behind the patient. To analyze the knowledge, awareness, and practice on conventional radiographic method and processing among the dental students. A well-framed questionnaire consisting of 10 questions were prepared and distributed among 100 dental professionals and students through the online Google forms link. The data were collected, tabulated in Excel sheets, and analyzed using the SPSS software. The Chi-square test was used to assess the P value. Sixty-five percentage of the participants are aware of conventional radiographic methods and 35% are not aware. The Chi-square test was done giving a P = 0.001 (

Context: High-frequency ultrasound (US) of painful rheumatoid joints allows an increasingly refined analysis of the extent of joint involvement and disease activity. Aims: The aim of this study was to establish the role of the US in the evaluation of painful hand joints in patients with rheumatoid arthritis (RA) and its comparison with Conventional Radiography (CR) changes. Settings and Design: Cross-sectional study. Subjects and Methods: Patients diagnosed with RA were assessed by a thorough clinical examination and relevant laboratory investigations. After X-ray imaging, grayscale, and power Doppler US examination of the wrist, metacarpophalangeal, and proximal interphalangeal joints of both hands were performed using a high-frequency linear transducer. Statistical Analysis Used: SPSS version 20.0 (a statistical package for the social sciences) was used to collect, tabulate, and analyze all data. The results were presented as mean standard deviation or percentage. Differences in categorical data were compared using the Chi-square test and Fisher's exact test. A P < 0.05 was considered statistically significant. Results: Thirty-two of the 51 individuals studied had radiographic abnormalities, whereas 44 had abnormal findings in the US. The US can detect erosions in 37 patients, including all 15 of those who had radiographically visible erosions. A statistically significant difference was noted between the findings of radiography compared with US findings (P < 0.001). Conclusions: US is more sensitive than CR for the detection of erosion and can complement the CR in the evaluation of these patients.

Teaching point: A linear flake of bone at the posterolateral aspect of the distal fibula indicates avulsion of the superior peroneal retinaculum and warrants further investigation by dynamic ultrasound.

Abstract Background Trabecular bone texture analysis (TBTA) has been identified as an imaging biomarker that provides information on trabecular bone changes due to knee osteoarthritis (KOA). Consequently, it is important to conduct a comprehensive review that would permit a better understanding of this unfamiliar image analysis technique in the area of KOA research. We examined how TBTA, conducted on knee radiographs, is associated to (i) KOA incidence and progression, (ii) total knee arthroplasty, and (iii) KOA treatment responses. The primary aims of this study are twofold: to provide (i) a narrative review of the studies conducted on radiographic KOA using TBTA, and (ii) a viewpoint on future research priorities. Method Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified. Results The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement. Conclusion Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.

Abstract Background The aim of the study is to assess the diagnostic value of preoperative conventional radiographs for diagnosing infection associated with internal fixation devices. Methods We prospectively collected data of patients undergoing removal of internal fixation devices for any reason. Infection was diagnosed in case of purulence, sinus tract, positive histopathology and/or positive peri-implant tissue or sonication fluid culture. In radiographs radiolucent lines, implant breakage or displacement, or periosteal reaction were assessed. White blood cell count (WBC) and serum C-reactive protein (CRP) were determined at admission. Results We included 421 surgeries in 380 patients (median age 53.6 years, range 11–98 years), mainly indicated for infection (24.9%), nonunion (20.0%) and symptomatic implants (13.5%). Radiologic signs of infection included radiolucent lines (11.4%); implant breakage (12.4%) or displacement (10.7%); and periosteal reaction (7.1%). Infection was confirmed in 116 cases (27.6%). Only radiolucent lines (OR = 1.86 [95%CI: 1.00–3.38]) and periosteal reaction (OR = 2.48 [95%CI: 1.17–5.26]) were associated with infection, with a low sensitivity (16.4 and 12.1%, respectively), and high specificity (90.5 and 94.8%, respectively). Preoperative WBC and CRP had a sensitivity of 23.0 and 35.3%, and specificity of 91.7 and 89.5%, respectively. Conclusions Radiological signs suggestive of infection were uncommon. Radiolucency and periosteal reaction were associated with infection, though with low sensitivity.

Teaching Point: A chondroid lipoma is a rare benign adipocytic neoplasm, containing a chondromyxoid matrix, that may mimic a myxoid liposarcoma and myxoid chondrosarcoma.

Introduction: Panoramic radiograph is an image used by the dentist to maintain diagnosis in dentistry, for example, to evaluate teeth condition in mixed dentition period. There are two panoramic radiography techniques, which are conventional and digital (direct and indirect) method. This study was aimed to analyse the differences of panoramic radiograph image quality between the conventional and digital indirect method on mixed dentition radiograph. Methods: Thirty samples of conventional and indirect digital panoramic radiograph were randomly taken from the database according to inclusion criteria. The image quality of conventional radiograph was manually assessed by using illuminator box, while indirect digital radiographs was assessed directly using DBS Win 5.7.0 software (Durr Dental, Germany). The radiographs were divided into six zones: teeth area, nasal and sinus, mandible, TMJ, ramus-spine, and hyoid bone. The image quality assessment was performed in each area based on three criteria: anatomical coverage, density and contrast, and anatomical structure. Results: The Cronbach's Alpha Intra-Class Correlation (ICC) inter and intraobserver agreement test of conventional and digital indirect methods on the aspect of anatomical, density and contrast coverage, and anatomic structure showed an excellent agreement. The independent sample t-test result showed significant difference (p < 0.05) between the conventional and indirect digital method in density and contrast as well as anatomical structure aspects, but not significantly different (p > 0.05) in the anatomical coverage aspect. Conclusion: Indirect digital panoramic radiograph shows better image quality as compared to conventional radiograph, especially in the anatomical structure aspect, density and contrast. There is no difference in the anatomical coverage aspect between conventional and indirect digital panoramic radiograph.

Background: Many imaging modalities have been in use for the evaluation of temporal bone lesions. Plain X-rays are cost-effective however; they provide limited details and hence sometimes may result in an inaccurate diagnosis. With the advent of HRCT, the method of imaging of temporal bone has evolved with special algorithms and multiplanar formats. In the present study, we tried to evaluate the different pathologies of the temporal bone with X-ray and HRCT. Methods: The study was conducted in the Departments of Otorhinolaryngology and Radiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of n=40 patients were identified and selected based on their symptoms and clinical findings suggestive of a lesion involving the temporal bone such as Otalgia, Otorrhoea, And Sensorineuronal deafness, pulsatile tinnitus, vertigo, and giddiness. These patients were subjected to high resolution computed tomography of the temporal bone on the 128 Slice CT Scanner (PHILIPS INGENUITY). The patients also underwent plain Radiography of temporal bone (CARESTREAM DRX-1 System). Results: Of the total n=40 patients studied the most common temporal bone disease was due to inflammation 85% and tumors were found in 15% of the patients. The common site of involvement of middle ear and mastoid air cells in chronic otitis media was epitympanum in n=30(90%) of cases, Mesotympanum in n=20(60%) of cases. In diseased ears, radiographs of the mastoids revealed pneumatised mastoid in 6(15%), diploic in 6(15%), and sclerosed mastoid in 28(70%) cases. HRCT temporal bone revealed pneumatised mastoid in 9(22.5%), diploic in 5(12.5%) and sclerosed mastoid in 26(65%) cases. Conclusion: The role of plain radiography is found to be limited to know the type of mastoid pneumatisation. It can also as Original Article detect bony erosion in few cases. Because of the ability to see temporal bone structures with great clarity, HRCT can be recommended not only in cases suspected with potential complications but also in all cases of temporal bone pathologies to know the extent of disease, inter-relationships of the tympanomastoid compartment with adjacent neurovascular structures, varied pneumatisation and the presence of anatomical variations, which should alert the clinician and guide in surgical approach and treatment plan.

Sialolithiasis is a common salivary gland disease. It may cause swelling of the gland, infection of the gland, or even death of glandular parenchymal cells. Various treatment modalities are available for management of sialolithiasis such as extracorporeal shock wave lithotripsy, sialoendoscopy, laser intracorporeal lithotripsy, interventional radiology, the video-assisted conservative surgical removal of the parotid, and submandibular calculi. These sophisticated procedures may not be available in all health-care centers. In this article, a new simple yet precise technique for management of ductal sialolith with minimum armamentarium is introduced.

Background: Accurate root canal length determination, simplicity of the procedure, and patient's cooperation are important determinants in the success of endodontic treatment in primary teeth. Aim: The aim of the study was to clinically compare the accuracy of Propex Pixi and Formatron D10 apex locators with conventional radiography in determining working length in mandibular primary second molars with and without varying degrees of physiological root resorption. Design: A nonrandomized clinical trial was conducted in 115 mandibular primary second molars indicated for pulpectomy in 90 pediatric dental patients. A single calibrated examiner determined the working length by conventional radiographic method and electronic apex locator (EAL) methods in a total of 376 canals. Behavior of the children during execution of each method in each tooth was recorded using the Frankl's behavior rating scale. The data obtained were tabulated and subjected to statistical analysis. Results: Significant correlation (intraclass correlation = 0.80 and 0.81, P < 0.001) could be detected between working length measurements obtained using Propex Pixi and Formatron D10 and measurements obtained using conventional radiography. Higher percentage of negative behaviors (negative and definitely negative) was observed during the conventional radiographic method (68.6%) as opposed to the Propex Pixi (16.5%) and Formatron D10 (20.8%) methods. Conclusions: Both the apex locators were as accurate as conventional radiography in determining working length in primary teeth; Formatron D10 being more accurate than Propex Pixi. The EALs were far better accepted by children than conventional radiography.

Purpose: To investigate the role of acromiohumeral distance (AHD) and critical shoulder angle (CSA) measurements from conventional radiographs (CR) in isolation and combined (prognostic index PIAHD-CSA) as predictors of full thickness rotator cuff tendon tears (RCT) and critical fatty degeneration (CFD; i.e. as much fat as muscle). Method: In this retrospective study AHD and CSA were measured in 127 CR. MR arthrograms served as reference standard and were screened for RCT and CFD. Statistical analysis for inter-reader agreement, Spearman’s rank correlation, linear stepwise regression and logistic regression for AHD and CSA with ROC analyses including PIAHD-CSA were performed. Results: In 90 subjects (17 females, mean age 36.1 ± 14.1) no RCT were found on MR imaging and served as control group. In 37 patients (13 females, mean age 58.7 ± 13.2) ≥ one RCT was found. Inter-reader agreements rated between к = 0.42–0.82 for categorical and 0.91–0.96 for continuous variables. No significant correlation of AHD and CSA with either age or sex was seen (p = 0.28 and p = 0.74, respectively). Case group had significantly smaller mean AHD (8.7 ± 3.2 vs. 10.8 ± 2.2 mm; p

Standard radiography in direct projection is the “gold standard” in the diagnosis of hand osteoarthritis (HOA). However, the currently clinically most severe “erosive” or “inflammatory” phenotype of HOA is characterized by the presence of inflammatory symptoms such as bone marrow lession (BML), synovitis and tenosinovitis, which are not visible on the radiograph by the nature of the study due to the low optical density. In addition, X-ray examination is planar and has no possibility of multiplanar visualization. This dictated the need to search for a more informative visualization technique in HOA.Aim – to compare the sensitivity and specificity of standard radiography and magnetic resonance imaging (MRI) techniques in determining the symptoms of osteoarthritis (OA) of the distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the right hand; to determine the indications for the appointment of MRI in patients with HOA.Materials and methods. The study included 64 women with clinically verified diagnosis of HOA according to ask criteria. For the first time, X-rays of the joints of the right hand in the anterior-posterior projection and MRI were performed for each of them. Each patient completed the AUSCAN questionnaire. X-rays were described according to the Kellgren and Lawrence systems, magnetic resonance imaging was analyzed according to the modified OHOA system. The sensitivity and specificity of the methods were compared based on the detection of 4 symptoms detected by radiography and MRI: joint space narrowing (JSN), osteophytes (OP), erosions and subluxations. The average age of the patients was 65.28±6.82 years, the age of onset was 48.81±7.73 years, the duration of the disease was 15.0 (10.0–19.5) years.Results. Both methods showed approximately equal identification JSN symptom in DIP and PIP, 95% definition JSN in MCP. OP were detected in 88% of patients in DIP according to radiography and in 95% – using MRI (p>0.05). In PIP OP were observed in 70% of patients on radiographs and in 86% on magnetic resonance imaging, in MCP – in 45% and 66% of cases, respectively. Erosion in DIP were found in 41% of patients according to MRI and 34% as a result of X-ray examination, in PIP – in 27% and 13% of cases, in MCP – in 60% and 8% of cases, respectively. Subluxations were determined in DIP 23% on radiographs in 31% of cases by MRI, in PIP – in 8% and 6% (p>0.05), in MCP subluxations almost never met – in 3% of cases by conventional radiography.Conclusions. MRI in HOA can be used in the detection of erosive process, differential diagnosis with other diseases of the joints, determination of inflammatory changes in the hands and assessment of their severity, but has no significant advantages over standard radiography in determining the symptoms of degenerative-dystrophic nature (JSN and OP). Subluxations of the MCP joints are not typical for the HOA.

Abstract Background To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-to-target. Methods Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, > 5 years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. Results In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from − 0,82; 0.68), nor for BA (varying from − 0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (− 1.48; − 0.68) compared to arm 1 (− 0.84; − 0.04) and arm 2 (− 0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p

The study aimed to determine the diagnostic possibilities of incipient apical root resorptions and the diagnostic sensibility of the conventional and digital radiography for small, medium and large apical root resorptions. To achieve this goal, it was performed an in vitro radiographic follow-up study on simulated root resorption cavities and a clinical and radiographic study on a patient’s group with chronic periapical lesions. Conventional radiography can be used as a reliable exam for early detection of medium and large root resorption cavities located in apical third. Digital radiography has higher sensitivity values for medium and large root resorption cavities. Detection percent for small radicular resorption cavities is inferior for both conventional and digital radiography. All periapical lesions can be considered an important etiological factor for the incipient, medium and severe external radicular resorptions. Radicular cysts and periapical diffuse osteitis represent potential etiological factors for severe apical root resorptions.

The purpose of this experimental study on recently deceased human cadavers was to investigate whether (I) the radiation exposure of the cervical spine CT can be reduced comparable to a dose level of conventional radiography (CR); and (II) whether and which human body parameters can be predictive for higher dose reduction potential (in this context). Materials and Methods: Seventy serial CT scans of the cervical spine of 10 human cadavers undergoing postmortem virtual autopsy were taken using stepwise decreasing upper limits of the tube current (300 mAs, 150 mAs, 110 mAs, 80 mAs, 60 mAs, 40 mAs, and 20 mAs) at 120 kVp. An additional scan acquired at a fixed tube current of 300 mAs served as a reference. Images were reconstructed with filtered back projection and the upper (C1-4) and lower (C4-7) cervical spine were evaluated by three blinded readers for image quality, regarding diagnostic value and resolution of anatomical structures according to a semiquantitative three-point-scale. Dose values and individual physical parameters were recorded. The relationship of diagnostic IQ, dose reduction level, and patients’ physical parameters were investigated. The high-contrast resolution of the applied CT protocols was tested in an additional phantom study. Results: The IQ of the upper cervical spine was diagnostic at 1.69 ± 0.58 mGy (CTDI) corresponding to 0.20 ± 0.07 mSv (effective dose) in all cadavers. IQ of the lower cervical spine was diagnostic at 4.77 ± 1.86 mGy corresponding to 0.560 ± 0.21 mSv (effective dose) in seven cadavers and at 2.60 ± 0.93 mGy corresponding to 0.31 ± 0.11 mSv in four cadavers. Significant correlation was detected for BMI (0.8366; p = 0.002548) and the anteroposterior (a.p.) chest diameter (0.8363; p = 0.002566), shoulder positioning (0.79799; p = 0.00995), and radiation exposure. Conclusions: Conventional radiography can be replaced with a nearly dose-neutral CT scan of the cervical spine.

Teaching Point: The imaging clues to differentiate idiopathic tumoral calcinosis from other calcified soft tissue lesions include: pseudotumoral appearance with mass effect, bone erosion with intra-osseous protrusion of calcification, lobulated morphology, and peri-articular location on the extensor side.

Background and Aim: Since the external root resorption is not detectable clinically, therefore radiographic examination is very important for diagnose, Therefore, the purpose of this study is to compare the diagnostic efficiency of conventional, digital and CBCT radiography in detecting of external root resorption. Materials and Methods: In this descriptive-analytic study, after radiographic and clinical examination, 20 single-rooted human premolar teeth without calcification and resorption were selected. Cavities were drilled 0.8 mm in diameter with round burs 08 in one-third of the cervical, mid, and apical of the buccal wall, digital and CBCT images were taken. The images were evaluated by 3 faculty members of Mashhad Dental School. The statistical analysis was performed with the SPSS V.18 software and Chi-Square test. The significance level was considered to be 0.05. Results: The ability to detect external resorption by CBCT was significantly higher than the other two methods (P=0.000). However, there was no significant difference between conventional and digital radiography. External resorption in the coronal, middle and apical were 78.7%, 62.3%, and 35.5%, respectively. Conclusion: According to the results, CBCT seems to be more reliable in determining external root resorption, in areas of maxillofacial superimposition, and in one-third of the apical root.

Context: Choosing an imaging source, which provides minimum radiation exposure to the patient, to facilitate surgical removal of impacted mandibular third molars (MTMs), thereby avoiding unwanted neurological complications. Aim: The aim of the study was to assess the efficacy of digital volume tomography (DVT) in evaluating the position of inferior alveolar canal (IAC) in relation to impacted MTMs and comparing it with conventional radiography (CR) in a subset of the Indian population. Materials and Methods: Four experienced observers assessed two groups: 33 DVT and 33 CR images, for the position of root-tips of impacted MTM in the proximity to IAC, in both vertical and horizontal planes. The diagnostic information was compared in both the groups. Statistical Analysis: Chi-square test, Mann–Whitney U-test, and Kappa statistics were used. Results: Comparison between DVT and CR revealed no statistically significant variation in assessing relationship in the vertical plane. There was, however, a significant difference between the groups, while comparing the diagnostic information for the horizontal dimension, for both the mesial and the distal roots, with an advantage for DVT (P < 0.05 for both mesial and distal roots). Conclusion: DVT is highly accurate in predicting neurovascular bundle exposure. It is indispensable for preoperative evaluation of impacted MTM.

Abstract Objectives The aim of this pictorial review is to illustrate the use of CBCT in a broad spectrum of musculoskeletal disorders and to compare its diagnostic merit with other imaging modalities, such as conventional radiography (CR), Multidetector Computed Tomography (MDCT) and Magnetic Resonance Imaging. Background Cone Beam Computed Tomography (CBCT) has been widely used for dental imaging for over two decades. Discussion Current CBCT equipment allows use for imaging of various musculoskeletal applications. Because of its low cost and relatively low irradiation, CBCT may have an emergent role in making a more precise diagnosis, assessment of local extent and follow-up of fractures and dislocations of small bones and joints. Due to its exquisite high spatial resolution, CBCT in combination with arthrography may be the preferred technique for detection and local staging of cartilage lesions in small joints. Evaluation of degenerative joint disorders may be facilitated by CBCT compared to CR, particularly in those anatomical areas in which there is much superposition of adjacent bony structures. The use of CBCT in evaluation of osteomyelitis is restricted to detection of sequestrum formation in chronic osteomyelitis. Miscellaneous applications include assessment of (symptomatic) variants, detection and characterization of tumour and tumour-like conditions of bone. Teaching Points • Review the spectrum of MSK disorders in which CBCT may be complementary to other imaging techniques. • Compare the advantages and drawbacks of CBCT compared to other imaging techniques. • Define the present and future role of CBCT in musculoskeletal imaging.

Abstract Background Ollier’s disease is a non-hereditary, benign bone tumor which is usually characterized by presence of multiple radiolucent lesions (enchondromas) in the metaphysis of long bones with unilateral predominance. The disease is a rare clinical entity with 1/100000 occurrence in early childhood. Patients mostly present with multiple hard swellings and deformity of the tubular bones specially hands and feet with leg discrepancy and pathologic fractures. Case presentation We present two cases of Ollier’s disease in a 13 years old female and 8 years old boy which had no specific symptoms. The girl had multiple hard swellings and deformity in the fingers of both hands and left toes with left leg deformity and discrepancy. Her plain radiographs demonstrated multiple expansile enchondromas in the phalanges of hands, left toes and metaphyses of upper humeri as well as left leg bones. The enchondromas were also noted in the left iliac bone and anterior end of ribs. The boy had bowing deformity and shortage of left leg with multiple enchondromas in the metaphyses of left femur, left tibia and fibula as well as left iliac bone in his radiographic images. Conclusion Ollier’s disease is usually diagnosed by clinical signs and typical location of enchondromas across skeleton in conventional radiography. It usually does not need specific treatment. Well understanding of the clinical manifestation and radiographic features can prevent unnecessary application of other imaging modalities; while other diagnostic imaging modalities like MRI, ultrasound and scintigraphy can be used in complicated and painful conditions.

Purpose/Objectives: To compare the diagnostic performance of dual-energy subtraction (DE) and conventional radiography (CR) for detecting pulmonary emphysema using computed tomography (CT) as a reference standard. Methods and Materials: Sixty-six patients (24 female, median age 73) were retrospectively included after obtaining lateral and posteroanterior chest X-rays with a dual-shot DE technique and chest CT within ±3 months. Two experienced radiologists first evaluated the standard CR images and, second, the bone-/soft tissue weighted DE images for the presence (yes/no), degree (1–4), and quadrant-based distribution of emphysema. CT was used as a reference standard. Inter-reader agreement was calculated. Sensitivity and specificity for the correct detection and localization of emphysema was calculated. Further degree of emphysema on CR and DE was correlated with results from CT. A p-value < 0.05 was considered as statistically significant. Results: The mean interreader agreement was substantial for CR and moderate for DE (kCR = 0.611 vs. kDE = 0.433; respectively). Sensitivity, as well as specificity for the detection of emphysema, was comparable between CR and DE (sensitivityCR 96% and specificityCR 75% vs. sensitivityDE 91% and specificityDE 83%; p = 0.157). Similarly, there was no significant difference in the sensitivity or specificity for emphysema localization between CR and DE (sensitivityCR 50% and specificityCR 100% vs. sensitivityDE 57% and specificityDE 100%; p = 0.157). There was a slightly better correlation with CT of emphysema grading in DE compared to CR (rDE = 0.75 vs. rCR = 0.68; p = 0.108); these differences were not statistically significant, however. Conclusion: Diagnostic accuracy for the detection, quantification, and localization of emphysema between CR and DE is comparable. Interreader agreement, however, is better with CR compared to DE

Background: Radiation doses and capability of EOS, conventional radiography (CR), and computed tomography (CT) to detect and measure enchondromas in a dedicated five-year-old anthropomorphic phantom were compared. Methods: To simulate enchondromas, minced pieces of chicken bone and cartilage were packed in conventional kitchen plastic foil to create ovoidal/rounded masses and randomly hung on the phantom. The phantom was imaged five times with CR, CT, and EOS, each time changing the number and position of inserts. All images were reviewed by a senior radiologist and a radiology resident. Results: EOS and CR detected all inserts in 4/5 cases (80%), while in one case 1/17 inserts was not seen. Excellent agreement of EOS with CR (88% reproducibility; bias = 14 mm; repeatability coefficient (CoR) 2.9; 95% CI from −2.8 to 3.1 mm; p = 0.5) and CT (81% reproducibility; bias = 15 mm; CoR 5.2; 95% CI from −5.5 to 5.2 mm; p = 0.7) was found. EOS showed 71% interobserver reproducibility (CoR 7.2; bias = 0.6 mm; 95% CI from −6.6 to 7.8 mm; p = 0.25). The EOS-Fast radiation dose was also significantly lower than the median radiation dose of CR (644.7 (599.4–651.97) mGy•cm2, p = 0.004). Conclusions: Low-dose EOS has the same capability as CR to detect and measure enchondroma-like inserts on a phantom and may be considered to monitor patients with multiple enchondromas.

Aims: We carried out a prospective study in order to identify the best imaging approach for patients with newly diagnosed multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS). Methods: We assessed the extent of myeloma bone disease (MBD) in 112 individuals - 84 patients with MM and 28 individuals with MGUS. For the detection of osteolytic involvement we used whole-body magnetic resonance imaging (WB-MRI), low-dose computed tomography (LD-CT) and conventional radiography (CR). Each method assessed the presence of osteolytic involvement, compressive fractures and extramedullary involvement in the following regions: skull, spine and chest, pelvis and humerus and femur. We compared the difference in the number and extent of osteolytic involvement, especially the findings in CR negative patients. Results: Conventional radiography showed no superiority in any of the evaluated regions, and failed in the detection of extramedullary massess and spine involvement. WB-MRI was best at imaging the spine including extramedullary involvement, however, detection of osteolytic lesions of the skull was limited in comparison with both CR and LD-CT. Both WB-MRI and LD-CT were comparable in imaging of lesions of pelvis, humerus, femur and the presence of extramedullary masses. LD-CT showed superiority in detection of skull lesions but lower sensitivity in spine compared to WB-MRI. Conclusions: Our results confirm that relying solely on CR in the diagnostics of MM is insufficient. We suggest that the most suitable method for primary assessment of osteolytic involvement in monoclonal gammopathies should include either whole-body MRI together with CR of the skull or, with an equivalent sensitivity, whole body LD-CT.

Background: The most efficient application of ionizing radiation is serving medical purposes and using this radiation has caused people to learn that artificial sources of radiation exposure among these resources can be of highest exposure rate. Obiective: The present study is aimed at initially establishing a baseline for localreference dose level in Mazandaran, Iran in 12 projections of the most conventional x-ray examination. Methods: In this study, 13 public hospitals in Mazandaran province were selected for review and required data collected for ten adult patients with mean weight of 70±10kg in each projection. Then, information of each center was separately analyzed. Next, in order to measure x-ray output tube, the dosimeter RTI model Barracuda calibrated has been applied for measuring air karma within energy rage of 40-150kvp. ESAK and ESD parameters, usually used for monitoring DRL in conventional radiography, were calculated. Results: Mean ESDs in this study has been obtained to 1.47±0.98 for skull (PA/ AP), 1.01±0.79 for skull (LAT), 0.67±0.38 for cervical spine (AP), 0.79±0.37 for cervical (LAT), 0.49±0.38 for chest (PA/AP), 1.06±0.44 for chest (LAT), 2.15±0.73 for thoracic spine (AP), 3±0.87 for thoracic spine (LAT), 2.81 ±0.82 for lumbar spine (AP), 4.28±0.78 for lumbar (LAT), 2.07±1.17 for abdomen and 1.90±0.99 for pelvis, respectively. The ESDs calculated for chest examination in both projections, PA and LAT are more than values recommended by the UK (2000), Brazil and Slovenia. Conclusion: The present study has determined wide variations in radiation dose of x-ray examinations among hospitals in Mazandaran, Iran. In order to reduce skin dose, an optimization procedure should be considered. Application of a reference dose (DRL) could be a practical method for this purpose. The role of optimization of radiography parameters for reducing patient dose is a significant issue. Through optimizing parameters, it would be possible to preserve image quality while reduction of patient dose.

Introduction: The aim of this study was to compare digital and conventional radiography in determining the working length of dilacerated canals.Methods: Thirty nine human extracted single-rooted teeth with root curvature more than 35 degrees were included in this study. After access preparation, a file was inserted into the canal and advanced until the file tip was visualized at the foramen. With measurement of the file length using a millimeter ruler, true canal length was determined for each canal. Then, teeth were mounted in acrylic blocks and canal length was estimated by using on-screen digital radiography with both 3- and 6-clicks measurement and from conventional radiography by conforming a preserved file on the image of the root canal.Results: There were no significant differences in measurement accuracy between the true canal length and conventional radiographic length, but there were significant difference between both digital radiographic techniques with true canal length. There was no significant correlation between root curvature and canal length estimation error of studied methods.Conclusion: In dilacerated canals, the accuracy of determination of working length by using conventional radiography is higher than digital radiography

Introduction: 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.

Introduction: Accurate diagnosis of periapical lesions may be necessary not only to predict the treatment outcome but also to decrease the incidence of root canal treatment failure. Ultrasound imaging is an easy, reproducible technique, which is based on the evaluation of reflected echoes and has the potential to differentiate the periapical lesions. Aim: To compare the diagnostic accuracy of conventional radiography, digital radiography, and ultrasound imaging in the detection of periapical lesions. Materials and Methods: Thirty patients aged between 20 and 40 years, presenting with well-defined periapical radiolucencies in relation to anterior maxillary or mandibular teeth, indicated for extraction or periapical surgery were subjected to conventional and digital radiographic examination by paralleling technique followed by ultrasonological examination. Three observers (A, B, C) gave their radiographic diagnosis twice at an interval of 2 weeks. A sonologist assessed the size, contents, echogenicity and vascular content of the lesions. The diagnosis was compared with histopathological examination of tissues obtained by extraction or periapical surgery. Results: The diagnostic accuracy of ultrasound imaging was 83.33%, which was higher than conventional radiographic examination by all observers (53.33-76.66%) and digital radiographs by observers A and B (70-80%). Conclusion: Our study revealed that ultrasound with color Doppler was an efficient tool for diagnosing periapical lesions as it had better diagnostic accuracy than conventional and digital radiography.

Aims and Objectives: The aim of this study was to investigate various lesions involving the oral and maxillofacial region by using scintigraphy and to compare the findings with those of conventional radiograph. Materials and Methods: Nineteen subjects of all age groups and both sexes who reported to the outpatient department of Oral Medicine and Radiology and had been clinically diagnosed with diseases of oral and maxillofacial region were selected. Conventional radiography and scintigraphy were performed for all the subjects. Biopsy and histopathological investigations were preformed to confirm the diagnosis and on the basis of which sensitivity, specificity, positive predictive value, and efficiency of conventional radiography and scintigraphy were evaluated. Results: Conventional radiography was found to have 94.11% sensitivity, 50% specificity, 94.11% positive predictive value, and 89.47% efficiency. Scintigraphy was found to have 100% sensitivity, 14.28% specificity, 66.66% positive predictive value, and 68.42% efficiency. Conclusion: Scintigraphy is a very sensitive diagnostic aid, but lacks in specificity. Conventional radiography, on the other hand, has good sensitivity and relatively better specificity. For a proper diagnosis, scintigraphic findings must be correlated with clinical, radiological, and histopathological findings.

Background and Aim: Recognition of factors that cause procedural errors in dental prac-tice and their prevention increase the success rate of endodontic treatment. This study aimed to evaluate the rate of procedural errors in a clinical training setting using conventional and digital radiography systems. Materials and Methods: In this study, digital and conventional radiographs available in the archives of the Department of Endodontics, Shahed School of Dentistry were used, including 684 conventional radiographs of 171 patients (treated by the 5th and 6th year un der-graduate dental students and the 1st and 2nd year post-graduate students) and 852 digi tal radiographs of 213 patients (treated by the 5th and 6th year under-graduate dental stu dents and the 1st, 2nd, and 3rd year post-graduate students). The errors investigated in this tudy included missing a canal, canal transportation, ledge formation, apical perforation, furcal perforation, strip perforation, overfilling, under-filling, poor obturation and broken instrument. Radiographs were examined by 3 observers in terms of type of error during endodontic treat ment. Once examined, cases that were agreed upon by at least two observers were accept-ed. Results: In the under-graduate student group, the most frequent errors found in conven tional radiographs were poor obturation and under-filling with 8.13% prevalence rate. The most frequent error in post-graduate student group was poor obturation as well with 10.58% frequency. In digital radiographs, in both under-graduate and post-graduate groups, the most frequent error was poor obturation, as well (11.86% in undergraduate and 9.47% in post-graduate groups). The number of error-free anterior teeth (82.05%) was significantly more than that of posterior teeth (65.29%)(p

Blunt chest trauma accounts for the majority of mortalities and morbidities in traumatized patients. Rib fractures are one of the most common chest wall injuries due to blunt chest trauma, which is estimated to occur in 10% of all traumatic injuries. Conventional radiography and ultra-sonography are two commonly methods used for rib fractures diagnosis with different accuracy. In this study, we described different methods used in diagnosis of injuries related to blunt chest trauma and we aimed to review several studies compared the diagnostic value of these methods.

Blunt chest trauma accounts for the majority of mortalities and morbidities in traumatized patients. Rib fractures are one of the most common chest wall injuries due to blunt chest trauma, which is estimated to occur in 10% of all traumatic injuries. Conventional radiography and ultra-sonography are two commonly methods used for rib fracture diagnosis with different accuracy. In this study, we described different methods used in diagnosis of injuries related to blunt chest trauma and we aimed to review several studies compared the diagnostic value of these methods.

Background and Aim: Due to the widespread use of lateral cephalometric radiography especially in orthodontic therapy and orthognathic surgery, obtaining radiographs of high quality with the least amount of radiation exposure is of utmost importance. The aim of this study was to compare the absorbed dose of head and neck target organs in conventional and digital lateral cephalometric radiography . Materials and Methods : In this experimental study, RANDO phantom was used for absorbed dose estimation in thyroid, parotid, pituitary and submandibular glands, bone marrow and ocular lens. The phantom was exposed 60 times: 30 times with CRANEX Tome, Soredex and 30 times with CRANEX D, Soredex with standard exposure settings. TLD (GR-200) dosimeters were used to measure organ doses. A total of 69 TLDs were used with 9 TLDs for background radiation. T-test was used for statistical analysis . Results: The mean absorbed dose of target organs was 0.04±0.005 mSv for conventional and 0.01±0.002 mSv for digital technique. The difference in absorbed dose in all target organs except for the thyroid gland (P=0.08) between the two techniques of conventional and digital was statistically significant. (P=0.01 ). Conclusion: Use of digital lateral cephalometric system causes a significant reduction in absorbed dose compared to the conventional film-screen system

Background and Aim: External root resorption is not detectable clinically and radiography plays a key role in its diagnosis.The present study aimed at comparing the diagnostic efficacy of conventional anddigital radiography in detection of simulated root resorption cavities (In-vitro ). Materials and Methods : This experimental observational study evaluated 39 extracted teeth. All roots, except for the palatal root of upper molars,were hypotheticallydividedinto apical and coronal sections.Half these sites were considered as the control group .Buccal cavities were randomly made in the remaining sectionsusing # 1/2,2 and 4 round burrs.Each tooth was imaged using a CCD-based digital system and E-speed film. Radiographs were taken at 0 and 20˚ mesial angulation .Six image groups were interpreted by two experienced oral and maxillofacial radiologists and one endodontist.Conventional and enhanced digital radiographs were also takenat 0 and 20˚ mesial angulation. Conventional radiographs were viewedat 2X magnification by a magnifying glass. Sensitivity, specificity,false positive and false negative percentages and accuracyof each method were compared with the gold standard. The degree of agreement among these techniques was measuredbykappa coefficient . Results: Conventional radiography at 2X magnification had the highest sensitivity and specificity. No significant difference was found in sensitivity of digital radiography and enhanced digital radiography. Enhanced digital radiography ranked second in terms of specificity. Conventional radiography at 2X magnification followed by enhanced digital radiography had the highest diagnostic accuracy. Mesial angulation of the cone increasedsensitivity and decreased specificity in all three techniques and thus, it only improved the diagnostic accuracy of digital radiography with no significant effect on the other two techniques.The degree of agreement between the two digital techniques was higher (k=0.68) . Conclusion: Diagnostic efficacy of conventional radiography at 2X magnification is more than digital radiographs for detection of external root resorption .

Background: Diagnosis of external root resorption (ERR) cavities may be challenging, especially when no clinical signs are seen. Therefore, the aim of this study was to compare the efficacy of conventional intraoral film radiography, charge-coupled device (CCD) detector, photostimulable phosphor plate (PSP) detector, and cone beam computed tomography (CBCT) for the detection of ERR. Methods: The study sample comprised 54 maxillary first premolars. Cavities were created by using a low-speed handpiece with round diamond burs of 1 mm in diameter. Digital and conventional radiographs were taken from each tooth. Three observers examined all images for the presence of resorption cavities. Data were statistically analyzed with the χ2 test. The reliability and degrees of agreement were also determined by the mean of Cohen's Kappa analysis. Results: The differences between the imaging methods in correct detection of root resorption for all sizes were not significant. For locations of root resorption, significant differences were found between CBCT and other methods in the apical regions. Conclusions: CBCT was only useful for detection of cavities located in the apical one-third of the root, compared to other digital or conventional methods.

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.

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.

Aim and Objective: To compare conventional and direct digital radiography (DDR) in working length measurement of the root canal and to assess the significance of the different enhancement modes provided by the software to visualize the file length. Materials and Methods: Access cavities were prepared in 30 extracted maxillary central incisors. Size 15 k-file was introduced into the canal till it was flush with the apical foramen. The working length was calculated as 0.5 mm less than the vernier caliper measured length of each file. The files were then sealed with resin at their respective lengths. Intraoral periapical radiographs and direct digital radiographs were taken. Vernier caliper was used to measure the file length in the periapical radiographs, and standard, positive conversion, and colorize modes were used with the CDR system. A multiple regression analysis was conducted to give an accurate analysis between the actual file length and the different groups. Results: There was no statistical significance between the different groups tested. The multiple regression analysis test showed that the positive and colorize modes more accurately corresponded to the actual file length. Conclusion: Both conventional radiography and DDR can be reliably used for working length determination. The positive and colorize modes enhancement features of DDR greatly improve the visual perception, leading to more accurate measurements.

مقدمه: نقایص استخوانی فک منشأ عوارض بسیاری برای بیماران می‏باشد و ترمیم کامل استخوان یک هدف ایده آل در درمان‏های رژنراتیو محسوب می‏شود. بررسی هیستولوژیک می‏تواند به عنوان یک معیار استاندارد مطرح باشد؛ اما در موارد بالینی تکنیک‏های تشخیصی غیرمهاجم مورد نیازاست. هدف از این مطالعه، بررسی دقت رادیوگرافی دیجیتال در مقایسه با رادیوگرافی معمولی در تعیین میزان ترمیم استخوان در طول زمان، بود. مواد و روش‏ها: در این تحقیق تجربی ابتدا دندان‏های پرمولر 4 سگ در هر چهار کوادرانت کشیده شد، سه ماه بعد در هر نیم فک در هر سگ، حفره‏ای به ابعاد mm5×5 ایجاد شد. 15، 30، 45 و 60 روز بعد، رادیوگرافی معمولی و دیجیتال از ناحیه به عمل آمد، در هر مرحله نمونه برداری انجام شد و مورد بررسی هیستومورفومتری قرار گرفت. در هر مرحله دانسیته استخوان در هر دو نوع رادیوگرافی مشخص شده و با درصد تشکیل استخوان تعیین شده به روش هیستومورفومتری مقایسه شد. اطلاعات به دست آمده با آزمون واریانس داده‏های تکراری و آزمون t زوج توسط نرم‏افزار SPSS آنالیز گردید. یافته‏ها: در همه زمان‏های مطالعه، اختلاف بین دو روش رادیوگرافی و هیستومورفومتری معنی‏دار بود. در روزهای 15 و 60، اختلاف معنی‏دار بین دو روش رادیوگرافی معمولی و دیجیتال وجود داشت؛ به طوری که اختلاف رادیوگرافی دیجیتال و هیستوموفومتری کمتر از رادیوگرافی معمولی و هیستومورفومتری بود. در حالی که در روزهای 30 و 45، اختلاف معنی‏داری بین دو روش رادیوگرافی مشاهده نشد. نتیجه گیری: با توجه به نتایج حاصل از این مطالعه، رادیوگرافی دیجیتال، مراحل اولیه و نهایی ترمیم ضایعات استخوانی را بهتر نشان می‏دهد.

Background: The carcinogenic effect of radiation is directly related to the exposure rate and the risk is even more in infants. The scope of the present study is to evaluate of the average of cumulative radiation dose in neonates in the neonatal surgery ward due to diagnostic and therapeutic radiologic procedures during the admission period, in Alzahra hospital of Isfahan, Iran. Methods: This investigation was a descriptive study on 168 neonates. It was done in neonatal surgery ward during last 9 months of 2009 in Alzahra hospital of Isfahan, Iran. The patients were selected randomly and with no attention to age, sex, diagnose and admision time. Thermo luminescent dosimeters (TLD GR200), were used for dosimetry and each chips was putted in a plastic envelope on the neonate sternum during the admission period. The cumulative absorbed dose by each patient was stored during the admission by TLD and followed by reading by TLD reader. For using of TLDs, they were calibrated and two calibration factors (individual and batch) were performed in radiotherapy section of Seyed Al-shohada hospital of Isfahan, Iran. After checking the accuracy of calibration, the absorbed dose by each patient was achieved by using of calibration factors. Finding: The average of admission time for each patient was 7.64 days and the average of cumulative absorbed dose was 3.13 Millisievert (mSv) during this time. The maximum absorbed dose in one patient was 42.83 mSv. The average number of conventional radiography for each patient was 2.77. The average of conventional radiography and cumulative absorbed dose in patient with no examination or just simple x-ray examinations was 2.58 and 0.863 mSv, respectively. Chest x-ray examination was the most examination used here (338 person). The average dose for each chest x-ray examination was 0.313 mSv. The average of cumulative absorbed dose among patients with fluoroscopic examination was about 12.6 mSv. The cumulative absorbed dose in 19 patients was more than 10 mSv. Conclusion: The average of cumulative absorbed dose was not more than the dose limit according to reference levels, but in comparison with other medical centers in the world is very high. Therefore, it is necessary to pay more attention to reduce radiological imaging procedures, particularly about fluoroscopic procedures.

This study compared Kodak Ektaspeed film and Dexis digital imaging systems for their diagnostic accuracy in detection of proximal canes in 210 proximal surfaces from 105 extracted human teeth (20 premolars and 85 molars), 129 of which were carious. Ground teeth were evaluated histologically. The images were assessed by an observer. ANOVA revealed that groups differ in scoring patterns with f-value of 26.72 and p < 0.01. The mean caries score by histologic assessment was significantly (p < 0.01) more when compared with the scores obtained by conventional and Dexis digital radiographic methods. The mean score for conventional radiographic method was slightly more than Dexis digital radiographic method, but the difference was statistically insignificant (p < 0.05). Both the radiographic methods were less accurate in detecting proximal canes confined to enamel, but as the lesion depth was increased to dentin, the rate of caries detection increased dramatically. It was concluded that both conventional and Dexis digital radiographic methods under estimated canes depth when compared with histologic method. Lastly, conventional film radiographs and Dexis digital radiographs did not perform significantly different from each other in the detection of canes.

Aim: The purpose of this study was to compare the Working length in primary teeth endodontics using intra oral digital radiovisiography and apex locator with conventional method for accuracy. Materials and Methods: This in vivo study was conducted on 30 primary teeth which were indicated for pulpectomy in the patients of the age group of 5-11 years All experimental teeth had adequate remaining tooth structure for rubber dam isolation and radiographicaly visible canals. Endodontic treatment was required due to irreversible pulpitis or pulp necrosis. A standardized intraoral periapical radiograph of the tooth was taken using conventional method by paralleling technique. The distance between the source and the tooth, tooth and the films were standardized using X-ray positioning device. During the pulpectomy procedure, the working length was determined by digital radiograph and apex locator. The measurements were then compared with the conventional method of root canal measurement technique for accuracy Result: From the results obtained we can conclude that Working length determined in primary molars using digital radiography and Apex locator did not show any significant difference in the mean working length measurements when compared with the conventional radiographic method. Conclusions: Apex locator is comparable to conventional radiograph in determining the working length without radiation in the primary teeth. Intraoral digital radiography is the safest method in determining the working length with significant reduction in radiation exposure.Hence, both the techniques can be safely used as alternatives to conventional radiographic methods in determining working length in primary teeth.

This study investigated the accuracy of diagnosing periapical lesions through conventional radiography (CR) and direct digital radiography (DDR) technique. A total of 170 patients with clinically suspected periapical pathosis and 30 normal subjects were included in the study. Both the conventional and digital images were taken with same exposure parameters keeping the film without lead foil and sensor simultaneously, to standardize the images. One endodontist and two oral radiologists evaluated all conventional and digital images and gave their final diagnosis for each technique separately. The diagnostic accuracy of each observer and image mode was calculated as the areas under receiver operating characteristic (ROC) curves. The mean values were statistically compared with the Wilcoxon′s signed rank test. In results the intraobserver variation and interobserver variation were high with conventional radiographic technique in diagnosing initial periapical lesions. There was a slight increase in the mean values for digital technique and in the accuracy of diagnosing the periapical lesions but using wilcoxon signed rank test the z-value was 1.367 and p-value was 0-172. The results of this study suggest that for the diagnosis of initial periradicular pathosis, the difference between the conventional and Trophy RVG 5000 DDR systems is insignificant However, some advantages like elimination of chemical processing, immediate observation of radiographic images, ability to enhance images, and data storage make DDR preferable in comparison with CR for diagnosis of initial periapical lesions.

Objective : To evaluate and compare the efficacy of conventional and digital radiographic methods in the detection of simulated external root resorption cavities and also to evaluate whether the detectability was influenced by resorption cavity sizes. Methods : Thirty-two selected teeth from human dentate mandibles were radiographed in orthoradial, mesioradial and distoradial aspect using conventional film (Insight Kodak F-speed; Eastman Kodak, Rochester, NY) and a digital sensor (Trophy RVG advanced imaging system) with 0.7mm and 1.0mm deep cavities prepared on their vestibular, mesial and distal surfaces at the cervical, middle and apical thirds. Three dental professionals, an endodontist, a radiologist and a general practitioner, evaluated the images twice with a one-week time interval. Results : No statistical significance was seen in the first observation for both conventional and digital radiographic methods in the detection of simulated external root resorptions and for small and medium cavities but statistical difference was noted in the second observation (P< 0.001) for both the methods. Conclusion : Considering the methodology and the overall results, conventional radiographic method (F-speed) performed slightly better than the digital radiographic method in the detection of simulated radiographic method but better consistency was seen with the digital system. Overall size of the resorption cavity had no influence on the performance of both methods and suggests that initial external root resorption lesion is not well-appreciated with both the methods as compared to the advanced lesion.

Bu çalışmanın amacı kök kanal boyutespitinde dijital radyografi ile elde edilen görüntülerin konvansiyonel radyografiylekarşılaştırılmasıdır. Çalışmamızda 50 adet tekköklü diş kullanılmıştır. Dişlerin kanal boyları konvansiyonel yöntem ve dijital radyografikullanılarak hesaplanmıştır. Dijital radyograficihazının yazılım programı kullanılarak ters, renkli ve 3 boyutlu görüntüleri elde edilmiştir. Dijital radyografi sistemi kalibre edildikten sonra elde edilen tüm görüntülerde kök kanal çal›şma boyutlar› hesaplanm›şt›r. Elde edilen tüm ölçüm değerlerinin normal dağ›l›m gösterip göstermediği Shapiro-Wilk testi ile kontrol edilmiştir. Gruplar›n birbiri ile karş›laşt›r›lmas›nda karş›laşt›rmal› t testi kullan›lm›şt›r. Gerçek boyut ile dijital orijinal görüntü karş›laşt›r›ld›ğ›nda istatistiksel olarak anlaml› bir fark tespit edilmemiştir p=0,904 . Gerçek boyut ile dijital değiştirilmiş görüntüler karş›laşt›r›ld›ğ›nda istatistiksel olarak anlaml› farkl›l›k tespit edilmiştir p

Bu çalışmanın amacı kök kanal boyutespitinde dijital radyografi ile elde edilen görüntülerin konvansiyonel radyografiylekarşılaştırılmasıdır. Çalışmamızda 50 adet tekköklü diş kullanılmıştır. Dişlerin kanal boyları konvansiyonel yöntem ve dijital radyografikullanılarak hesaplanmıştır. Dijital radyograficihazının yazılım programı kullanılarak ters, renkli ve 3 boyutlu görüntüleri elde edilmiştir. Dijital radyografi sistemi kalibre edildikten sonra elde edilen tüm görüntülerde kök kanal çal›şma boyutlar› hesaplanm›şt›r. Elde edilen tüm ölçüm değerlerinin normal dağ›l›m gösterip göstermediği Shapiro-Wilk testi ile kontrol edilmiştir. Gruplar›n birbiri ile karş›laşt›r›lmas›nda karş›laşt›rmal› t testi kullan›lm›şt›r. Gerçek boyut ile dijital orijinal görüntü karş›laşt›r›ld›ğ›nda istatistiksel olarak anlaml› bir fark tespit edilmemiştir p=0,904 . Gerçek boyut ile dijital değiştirilmiş görüntüler karş›laşt›r›ld›ğ›nda istatistiksel olarak anlaml› farkl›l›k tespit edilmiştir p

Araştırmamızda kök kanal boyu tespitindedijital radyografiler in vivo şartlarda elektronikapeks bulucu ve konvansiyonel radyografilerlekarşılaştırıldı.Çalışmamızda 103 adet dişten yararlanıldı.Dişlerin giriş kavitesi açıldıktan sonra elektronikapeks bulucu ile kök kanal boyu tespit edildi. Dahasonra konvansiyonel ve dijital radyografik görüntüler elde edildi. Elde edilen görüntülerden konvansiyonel radyografilerde standart yöntem ile, dijital radyografilerde ise yaz›l›m program› kullan›- larak kök kanal boylar› saptand›. Elde edilen değerler istatistiksel olarak tekrarlanan ölçümlü ANOVA ve Bonferroni çoklu karş›laşt›rma testi ile değerlendirildi. Çal›şma bulgular›na göre gruplar aras›nda istatistiksel aç›dan anlaml› bir fark bulunamad›. Bu nedenle dijital yöntemin diğer yöntemlerle k›yasland›ğ›nda endodontik aç›dan kök kanal boyu tespiti ve diğer endodontik değerlendirmelerde kabul edilebilir olduğu sonucuna var›ld›.