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A contemporary perspective on techniques for the clinical assessment of alveolar bone.

Radiographic techniques, traditional ones as well as newer ones under development, for clinically assessing alveolar bone are critically assessed. Traditional intraoral radiography is reexamined, in particular with regard to the accuracy with which the alveolar crest is seen. Evidence is presented for a more accurate representation of the alveolar crest on bitewings rather than periapical films. Application in periodontics of newer radiographic techniques, subtraction radiography, and single and dual photon aborptiometry presently under clinical development are discussed in regard to their potential and limitations. Similarly, radiopharmaceuticals to evaluate the metabolic status of alveolar bone are discussed as well as the potential for using analyses of gingival crevice fluid as a window for assessment of alveolar crest metabolism.

Absorptiometry, Photon↗

Collective dose to the Swedish population from intraoral radiography.

In 1984 the Swedish National Institute of Radiation Protection (SSI) undertook an investigation (KAST) of 400 randomly selected dental offices to check the extent to which the new rules and recommendations concerning radiation protection (SSI 1978, 1980) were applied. Data for calculation of the energy imparted per bitewing examination of an adult were available. The information obtained was utilized for estimating the collective dose in Sweden from intraoral radiography. The mean value of the energy imparted from an ordinary bitewing examination was 0.48 mJ. The quotient between the sum of all imparted energy during 1984, 5,519 J, and the number of inhabitants in that year was 0.66 mJ. This corresponds to 1.5 ordinary bitewing examinations per individual in Sweden. The collective effective dose equivalent is 79 manSv after transformation from the total energy imparted. The average energy imparted from the annual natural irradiation in Sweden is 100 mJ, with variations between 35 and 350 mJ, giving totally to the population 830,000 J. The dose contribution from intraoral radiography is thus considered of minor importance when taking into account the variations of the natural irradiation as well as the benefit of the diagnostic gain in dentistry and the enhancement of public dental health.

Adult↗

[Caries diagnosis of deciduous teeth, value of radiography].

Deciduous molars of 10-11 year-old children were examined clinically and radiologically for caries. The findings were compared. Without the radiological evidence of the bitewing pictures about 66% of proximal caries of deciduous molars would have been overlooked. Moreover, the lesions could be detected earlier.

Child↗

The occlusal radiograph revisited.

The purpose of this paper is to demonstrate occlusal radiography as an important projection for diagnostic purposes in general dental practice. There are many instances where bitewing and periapical radiographs are insufficient to demonstrate pathoses adequately. A descriptive and photographic review of the different occlusal projections and a series of illustrative cases demonstrating their diagnostic relevance is provided.

Humans↗

[The necessity of bite wing registration for the diagnosis of caries].

This study points out the importance of the radiograph, particularly bitewing films, for diagnosing caries in interproximal regions. The assertion that interproximal caries may be optimally diagnosed without radiographs was investigated. Two clinical examinations of the same patient were compared with two evaluations of the bitewing film.

Bicuspid↗

Clinical evaluation of a samarium/aluminum compound filter.

Rare earth compound filters, which offer reduced patient exposure during intraoral radiography, have not been clinically evaluated for their effect on diagnostic yield. This clinical study was conducted to compare the diagnostic yield of bitewing radiographs exposed with a conventional aluminum filter with matched bitewing radiographs exposed with a samarium/aluminum compound filter. One hundred sixty-three pairs of bitewing radiographs were read independently by two reviewers for absence or presence and depth of proximal carious lesions. Degree of agreement between films was assessed by means of the kappa statistic. Results showed good agreement between the radiographs exposed with each filter type. Thus, x-ray machines modified with a samarium/aluminum rare earth compound filter produce bitewing radiographs of comparable diagnostic yield and lower dose when compared with radiographs exposed with a conventional aluminum filter.

Adult↗