1
|
Korkmaz MZ, Altin A, Günaçar DN, Köse TE. Comparison of trabecular bone structure in individuals with healthy periodontium and stage III/IV, grade C periodontitis by fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:427-432. [PMID: 36328893 DOI: 10.1016/j.oooo.2022.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim was to perform fractal analysis (FA) to compare differences in trabecular microarchitecture in interdental and antegonial regions on panoramic radiographs in periodontally healthy patients and those with stage III/IV, grade C periodontitis, and to compare the effects of patient age and sex on FA results. STUDY DESIGN Clinical and radiographic records from 33 periodontally healthy individuals and 28 individuals with aggressive periodontitis were obtained from the faculty archives. Three regions of interest (ROIs) were chosen bilaterally from interdental bone around the mandibular first molar and canine and the antegonial region. The mean fractal dimension (FD) values of the ROIs were calculated. Significance of differences was established at P < .05. RESULTS FD values of all 3 ROIs in the periodontitis group were significantly lower than values in the control group (P ≤ .004). FD was not affected by patient age (P = .357) or sex (P = .216). There were no significant correlations between FD and age in either group (P ≥ .093). FD values differed significantly between sexes in only one ROI. CONCLUSIONS FA can effectively detect trabecular microarchitectural differences in patients with aggressive periodontitis compared to periodontally healthy individuals. This technique might be useful in predicting the susceptibility of patients to periodontal disease.
Collapse
Affiliation(s)
- Meltem Zihni Korkmaz
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Periodontology, Rize, Turkey.
| | - Ahmet Altin
- İstanbul Kent University, Faculty of Dentistry, Department of Periodontology, İstanbul, Turkey
| | - Dilara Nil Günaçar
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Rize, Turkey
| | - Taha Emre Köse
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Rize, Turkey
| |
Collapse
|
2
|
Gillies RC, Quiñonez C, Wood RE, Lam EWN. Radiograph prescription practices of dentists in Ontario, Canada. J Am Dent Assoc 2021; 152:284-292. [PMID: 33637300 DOI: 10.1016/j.adaj.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/24/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND With the advent of new ionizing radiation technologies, consideration must be given to the use of radiography in clinical practice. The authors aimed to determine how general dentists obtain oral and maxillofacial images and whether dentists' demographic characteristics and practice environments affect imaging decisions. METHODS The authors conducted a cross-sectional study using an electronic survey to collect information from general dentists in Ontario, Canada's most populous province. RESULTS The authors received 1,332 responses from 9,052 general dentists registered to practice in Ontario. A total of 57.2% of dentists used a nonindividualized approach to obtaining images for new adult dentate patients. Using clinical case scenarios, the authors found that 18.8% through 55.1% of dentists did not follow evidence-based guidelines when obtaining images. Overprescribing imaging was 5.8 times more common than underprescribing. Seeing patients after images were obtained (odds ratio [OR], 5.5), owning a panoramic and a cone-beam computed tomography imaging system (OR, 4.4), and the belief that images should be obtained to screen for occult pathoses (OR, 3.5) were the factors most strongly associated with overprescription. CONCLUSIONS Radiography prescription practices varied considerably among general dentists in Ontario and did not conform to established guidelines. Factors other than patient needs appeared to influence imaging practices. PRACTICAL IMPLICATIONS Overprescription of imaging by general dentists can result in unnecessary radiation exposure and financial costs to patients. To mitigate this, changes are needed in dental education, continuing education courses, and regulatory requirements.
Collapse
|
3
|
Dave M, Barry S, Henderson N, Loughlin A, Walker E, Davies J. Evaluating compliance of dental radiography for paediatric patient assessment in specialised tertiary care units: a United Kingdom multi-centre survey. Br Dent J 2021; 229:184-189. [PMID: 32811946 DOI: 10.1038/s41415-020-1921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Aim The aim of this survey was to determine compliance towards dental radiography selection criteria for paediatric patients undergoing new patient examinations in specialised tertiary care centres in the United Kingdom.Methods Five university-associated dental hospitals were included in this study. Retrospective data was collected reviewing all paediatric patients on the new patient assessment clinics, where dental imaging was requested or the patient had relevant previous imaging. Data was collected from 28 June 2018, continuing retrospectively for a maximum of six months or until 150 patients were reached. Patients referred solely for orthodontic assessment were excluded.Results Seven hundred and fifty patients were included with an average age of eight years - 95.5% of patients had a radiographic justification provided. All patients were grouped into 56 disease categories and a total range of one cross-sectional and nine planar radiographs were prescribed in this cohort. Each radiograph was assessed for compliance to the Faculty of General Dental Practice, European Association of Paediatric Dentistry and national Italian guidelines for dental diagnostic imaging. Additionally, selection criteria for CBCT scans were taken from SEDENTEXCT guidelines. Full panoramic radiographs were the most commonly prescribed at 34.8% (n = 261). However, this demonstrated the lowest compliance rate as per selection criteria at 75.9%. This was due to referrers requesting radiographs primarily for assessing dental development (18.8%; n = 49) and caries assessment (2.7%; n = 7). Other radiograph formats demonstrated varying levels of guideline compliance ranging from 93.5-100%.Conclusion This study identifies common radiograph request errors and can inform paediatric clinicians to improve compliance to guidelines and reduce radiation exposure to young patients.
Collapse
Affiliation(s)
- Manas Dave
- NIHR Academic Clinical Fellow in Oral and Maxillofacial Pathology, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK.
| | - Siobhan Barry
- Professor and Honorary Consultant in Paediatric Dentistry and Honorary Consultant in Paediatric Dentistry, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK
| | - Neil Henderson
- Specialty Trainee in Dental and Maxillofacial Radiology, Dental Radiology Department, Level 3, Glasgow Dental Hospital & School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK
| | - Amanda Loughlin
- Specialty Trainee in Dental and Maxillofacial Radiology, Department of Dental Radiology, Guy's Hospital, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK
| | - Edward Walker
- Specialty Trainee in Dental and Maxillofacial Radiology, Department of Dental Radiology, Leeds Dental Institute, The Worsley Building, Clarendon Way, Leeds, LS2 9LU, UK
| | - Jonathan Davies
- Consultant in Dental and Maxillofacial Radiology, Department of Dental Radiology, Guy's Hospital, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK
| |
Collapse
|
4
|
Vesala T, Ekholm M, Ventä I. Is dental panoramic tomography appropriate for all young adults because of third molars? Acta Odontol Scand 2021; 79:52-58. [PMID: 32529875 DOI: 10.1080/00016357.2020.1776384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to determine, if a dental panoramic tomograph (DPT) is appropriate for every young adult due to third molars. MATERIALS AND METHODS The study sample consisted of 217 university students (20% men and 80% women; mean age 20.7 years; SD ± 0.6 years) and included a questionnaire about symptoms caused by third molars, clinical oral examination of third molars, and a DPT. Subjects were divided into the following groups: subjects with a clinical indication for a DPT and subjects without such indication. The DPTs were then examined for findings regarding third molars. RESULTS Clinical indication for a DPT was observed in 64% of the subjects. Radiography revealed an additional 1.4% of the subjects with ≥1 radiographic signs of disease in relation to their third molars. Also, an additional 27% of the subjects had ≥1 other radiographic findings in relation to third molars that may have affected the clinical decision making. CONCLUSIONS In our study population, clinically undetectable pathology cannot be considered as an indication for a DPT. However, if prevailing clinical practice supports preventive removals and detecting or monitoring of unerupted third molars, a referral to DPT can be considered as good clinical practice.
Collapse
Affiliation(s)
- Tommi Vesala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Marja Ekholm
- Institute of Dentistry, University of Turku, Turku, Finland
- South West Finland Imaging Centre, Turku University Hospital, Turku, Finland
| | - Irja Ventä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| |
Collapse
|
5
|
Kratz RJ, Walton JN, MacEntee MI, Nguyen CT, MacDonald D. Panoramic radiographs made before complete removable dental prostheses fabrication: A retrospective study of clinical significance. J Prosthet Dent 2016; 118:26-30. [PMID: 28024823 DOI: 10.1016/j.prosdent.2016.09.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM The value of digital panoramic radiographs to screen for problems before fabricating conventional complete dentures is unclear. PURPOSE The purpose of this retrospective study was to examine the influence of pretreatment digital panoramic radiographs on the clinical management of patients receiving complete removable dental prostheses. MATERIAL AND METHODS The clinical records, including panoramic radiographs, of 169 patients seeking new complete removable dental prostheses over a 6-year period were interpreted independently by both a prosthodontist and an oral and maxillofacial radiologist to identify radiographic findings that influenced clinical patient management. A 95% confidence interval and an observed proportion of agreement were used to interpret the results. RESULTS Sixty percent of the 169 radiographs examined had 1 or more abnormal or positive radiographic findings; however, only 6 (<4%) of 165 abnormalities detected influenced patient management, and 3 of them were identified during the clinical examination. CONCLUSIONS Pretreatment digital panoramic radiographs revealed very few abnormalities that influenced the treatment of patients requiring complete removable dental prostheses. Furthermore, the digital images in this study revealed positive findings at a rate similar to those found in studies assessing analog radiographs, reinforcing current guidelines that recommend against radiographic screening of patients who seek new complete removable dental prostheses.
Collapse
Affiliation(s)
| | - Joanne N Walton
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Michael I MacEntee
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Caroline T Nguyen
- Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada; and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - David MacDonald
- Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological and Medical Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| |
Collapse
|
6
|
Beddis HP, Davies SJ, Budenberg A, Horner K, Pemberton MN. Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety. Br Dent J 2014; 217:351-355. [DOI: 10.1038/sj.bdj.2014.862] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/09/2022]
|
7
|
Moll MA, Seuthe M, von See C, Zapf A, Hornecker E, Mausberg RF, Ziebolz D. Comparison of clinical and dental panoramic findings: a practice-based crossover study. BMC Oral Health 2013; 13:48. [PMID: 24066660 PMCID: PMC4015768 DOI: 10.1186/1472-6831-13-48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 09/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated. METHODS Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes. RESULTS Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes. CONCLUSIONS With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found.
Collapse
Affiliation(s)
- Marc A Moll
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Centre, Robert-Koch Str, 40, Goettingen D-37075, Germany.
| | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
|