OHSU

Radiographic Interpretation 2009

Objectives and Goals

  • Understand the basics of radiation physics and the effects of various radiographic factors on the quality of x-rays.
  • Know why it is beneficial to change horizontal and vertical angulations when taking x-rays.
  • Know and understand the Buccal Object Rule.
  • Know the limitations of image interpretation as it applies to the present modes of image generation.
  • Be conversant with the latest image technologies.

Text: Ingle's Endodontics, 6th Edition Chapters 15 and 16. Read for understanding. Do not abstract.

Study questions for Classic Literature seminar on Endodontic Radiology

1. Which bone type in jaw has least amount of mineral per unit volume?

2. What is the limit of the human eye in detecting line pairs per mm?

3. What has been the presumed difference between a cyst and a granuloma on an x-ray image?

4. What does CMOS stand for?

5. What is DICOM and how is it used?

6. According to Bianchi et al what bony changes detected by CT seem to be pathognomonic for bisphosphonate osteonecrosis?

7. According to Patel et al what is the size of the voxel in CBCT?

Literature Assigned:

Goldman M, Pearson AH, Darzenta N. Endodontic success – Who's reading the radiograph? Oral Surg 1972;33:432-437.

Bender IB. Factors influencing the radiographic appearance of bony lesions. J Endod 1982;8:161-170.

Antrim DD. Reading the radiograph: A comparison of viewing techniques. J Endod 1983;9:502-505.

Lee S-J, Messer HH. Radiographic appearance of artificially prepared periapical lesions confined to cancellous bone. Int Endo J 1986;19:64-72.

Yokota ET, Miles DA, Newton CW, Brown CE. Interpretation of periapical lesions using RadioVisioGraphy. J Endod 1994;20:490-494.

Molven O, Halse A, Fristad I. Long-term reliability and observer comparisons in the radiographic diagnosis of periapical disease. Int Endo J 2002;35:142-147.

Folk RB, Thorpe JR, McClanahan SB, Johnson JD, Strother JM. Comparison of two different direct digital radiography systems for the ability to detect artificially prepared periapical lesions. J Endod 2005;31:304-306.

Wenzel A, Kirkevang L-L. High resolution charge-coupled device sensor vs. medium resolution photostimulable phosphor plate digital receptors for detection of root fractures in vitro. Dent Traumatol 2005;21:32-36.

Woolhiser GA, Brand JW, Hoen MM, Geist JR, Pikula AA, Pink FE. Accuracy of film-based, digital, and enhanced digital images for endodontic length determination. Oral Surg 2005;99:499-504.

Ricucci D, Mannocci F, Pitt Ford TR. A study of periapical lesions correlating the presence of a radiopaque lamina with histological findings. Oral Surg 2006;101:389-394.

Huumonen S, Kvist T, Grondahl K, Molander A. Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars. Int Endo J 2006;39:827-833.

Nair MK, Nair UP. Digital and advanced imaging in endodontics: A review. J Endod 2007;33:1-6.

Bianchi SD, Scoletta M, Cassione FB, Migliaretti G, Mozzati M. Computerized tomographic findings in bisphosphonate-associated osteonecrosis of the jaw in patients with cancer. Oral Surg 2007;104:249-258.

Patel S, Dawood A, Pitt Ford T, Waites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endo J 2007;40:818-830.

Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008;34:273-279.

Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pecora JD. A new periapical index based on cone beam computed tomography. J Endod 2008;34:1325-1331.

Liedke GS, da Silveira HED, da Silveira HLD, Dutra V, de Figueiredo JAP. Influence of voxel size in the diagnostic ability of cone beam tomography to evaluate simulated external root resorption. J Endod 2009;35:233-235.

Moura MS, Guedes OA, De Alencar AHG, Azevedo BC, Estrela C. Influence of length of root canal obturation on apical periodontitis detected by periapical radiography and cone beam computed tomography. J Endod 2009;35:805-809.

Optional

Shawkat AH et al. evaluation of the utilization of the supine position in intraoral radiology. Oral Surg 43:963. 1977.       

Richards AG.  The buccal object rule.  Dent Radiog Photog 53:37. 1980.           

Thunthy KH, Weinberg R.  Comparison of films processed in automatic and manual processors.  Oral Surg 50:479. 1980.

Bhakdinaronk A, Mason-Hing LR. Effect of radiographic technique upon prediction of tooth length in intraoral radiology. Oral Surg 51:100. 1981.

Thunthy KH, Wineburg R. Sensitometric comparison of dental films of groups D and E. Oral Surg 54:250. 1982.

Girsch WJ, Matteson SR, McKee MN.  An evaluation of Kodak Ektaspeed periapical film for use in endodontics.  J Endodon 9:282. 1983.

Leff GS, Schwartz SF, del Rio CE.  Xeroradiographic interpretation of experimentally induced jaw lesions.  J Endodon 10:188. 1984.

Zakariasen et al. Endodontic recall radiographs: how reliable is our interpretation of endodontic success or failure and what factors affect reliability? Oral Surg 57:343. 1984.

X-rays in Dentistry.  Eastman Kodak Co.; Rochester, NY. p4-22. 1985.

Andreasen et al. Radiologic assessment of simulated root resorption cavities. Endod Dent Traumatol 3:21. 1987.

Shearer et al. Radiovisiography for imaging root canals: an in vitro comparison with conventional radiography. Quint Int 21:789. 1990.

Tyndall DA, Kapa SF, Bagnell CP.  Digital subtraction radiography for detecting cortical and cancellous bone changes in the periapical region.  J Endodon 16:173. 1990.

Tachibana H, Matsumoto K.  Applicability of X-ray computerized tomography in endodontics.  Endod Dent Traumatol 6:16. 1990.

Neaverth EJ, Pantera EA.  Chairside disinfection of radiographs.  Oral Surg 71:116-119. 1991.

Nattress BR, Martin DM.  Predictability of radiographic diagnosis of variations in root canal anatomy in mandibular incisor and premolar teeth.  Int Endo J 24:58. 1991.

American Academy of Oral and Maxillofacial radiology infection control No Abguidelines for dental radiographic procedures.Oral Surg 73:248-249. 1992.

Forsberg J, Halse A.  Radiographic simulation of a periapical lesion comparing the paralleling and the bisecting angle techniques.  Int Endodon J 27:133-138. 1994.

Monahan R, Alder M, Nummikoski P.  Magnetic resonance imaging: practical theory and clinical relevance.  J Amer Dent Assoc 125:998-1002. 1994.

Geist JR, Gleason MJ.  Densitometric properties of rapid manual processing solutions: abbreviated versus complete rapid processing. J Endodon 21:180-184. 1995.

Scarfe WC, Fana CR, Farman AG.  Radiographic detection of accessory/lateralcanals:use of Radiovisiography and Hypaque.  J Endodon 21:185-190.  1995.

Tirrell BC, Miles DA, Brown CE, Legan JJ.  Interpretation of chemically created lesions using direct digital imaging.  J Endodon 22:74-78.  1996.

Wallace J, Nair M, Colaco M, Kappa S. A comparative evaluation of the diagnostic efficacy of film and digital sensors for detection of simulated periapical lesion. Oral Surg Ora Med Oral Path Oral Radiol Endod 92:93. July, 2001.

Delano E, Ludlow J, Orstavik D, Tyndall D, Trope M. Comparison  between PAI and quantitative digital radiographic assessment of apical healing after endodontic treatment. Oral Surg Ora Med Oral Path Oral Radiol Endod 92:108. July, 2001.

Friedland B, Faiella R, Bianchi J. Use of rotational tomography for assessing internal resorption. J Endodon 27:797. December, 2001.

Nielsen C. Effect of scenario and experience on interpretation of mach bands. J Endodon 27:687. November, 2001.

Mentes A, Gencoglu N. Canal length evaluation of curved canals by direct digital or conventional radiography. Oral Surg Ora Med Oral Path Oral Radiol Endod 93:88. July, 2002.

Brunton P, Abdeen D, Macfarlane T. The effect of an apex locator on exposure to radiation during endodontic therapy. J Endodon 28:524. July, 2002

Yoshioka T, Kobayashi C, Suda H, Sasaki T. An observation of the healing process of periapical lesions by digital subtraction radiography. J Endodon 28:589. August, 2002.

Halse A, Molven O, Frisatd I. Diagnosing periapical lesions – disagreement and borderline cases. Int Endo J 35:703. 2002.

Siragusa M & McDonnell DJ. Indirect digital images: limit of image compression for diagnosis in endodontics. Int Endo J 35:991. 2002.

Nauom HJ, Love RM, Chandler NP, Herbison P. Effect of X-ray beam angulation and intraradicular contrast medium on radiographic interpretation of lower first molar root canal anatomy. Int Endo J 36:12. 2003.

von Strechow D, Balto K, Stashenko P, Müller R. Three-dimensioal quantitation of periradicular bone destruction by micro-computed tomography. J Endod 29:252. April, 2003.

Nauom HJ, Chandler NP, Love RM. Cinventional versus storage phosphor-plate digital images to visualize the root canal system contrasted with a radiopaque medium. J Endod 29:349. May, 2003.

Kositbowornchai S, Sikam S, Nuansakul R, Thinkhamrop B. Root fracture detection on digital images: effect of the zoom function. Dent Traumatol 19:154. June, 2003.

Sheaffer JC, Eleaser PD, Scheetz JP, Clark SJ, Farman AG. Endodontic measurement accuracy and perceived radiograph quality: Effects of film speed and density. OOOO&E 96:441. October, 2003.

Tagger M & Katz A. Radiopacity of endodontic sealers: development of a new method for direct measurement. J Endod 29:751. November, 2003.

Newman ME & Friedman S. Extraoral radiographic technique: an alternative approach. J Endod 29:419. June, 2003.

Bernstein DI, Clark SJ, Scheetz JP, Farman AG, Rosenson B. Perceived quality of radiographic images after rapid processing of D- and F- speed direct-exposure intraoral x-ray films. OOOO&E 96:486. October, 2003.

Barton DJ, Clark SJ, Eleazer PD, Scheetz JP, Farman, AG. Tuned-aperture computed tomography versus parallax analog and digital radiographic images in detecting second mesiobuccal canals in maxillary first molars. 96:223. August, 2003.

Yoshioka T, Villegas JC, Kobayashi C, Suda H. Radiographic Evaluation of root canal multiplicity in mandibular first premolars. J Endod 30:73. February, 2004.

Li G. Comparative investigation of subjective image quality of digital intraoral radiographs processed with 3 image-processing algorythems. OOOO&E 97:762. June, 2004.

Mikrogeorgis G, Lyroudia K, Molyvdas I, Nikolaidis N, Pitas I. Digital radiograph registration and subtraction: a useful tool for the evaluation of the progress of chronic apical periodontitis.  J Endod 30:513. July, 2004.

Bedford JM, Martin DM, Youngson CC. Assessment of a contrast medium as an adjunct to endodontic radiography. Int Endo J 37:806. 2004.

Jett S, Shrout MK, Mailhot JM, Potter BJ, Borke JL. An evaluation of the origin of trabecula bone patterns using visual and digital image analysis. OOOO&E 98:598. November, 2004.

Camps J, Pommel L, Bukiet F. Evaluation of periapical lesion healing by correction of gray values. J Endod 30:762. November, 2004.

Benjamin SD. Digital radiography: more than meets the eye. Compendium 26:464. June, 2005.

Wenzel A, Kirakevang L-L. High resolution charge-coupled device sensor vs. medium resolution photostimuable phosphor plate digital receptors for detection of root fractures in vitro. Dent Traum21:32. 2005.

Chen S-K, Oviir T, Lin C-H, Leu L-J, Cho B-H, Hollender L. Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following enddontic treatment. OOOO&E 100:467. October, 2005.

Bhaskaran V, Qualtrough AJE, Ruston VE, Worthington HV, Horner K. A laboratory comparison of three imaging systems for image quality and radiation exposure characteristics. Int Endo J 38:645. 2005.

Ricucci D, Mannocci F, Pitt Ford TR. A study of periapical lesions correlating the presence of a radioopaque lamina with histological findings. OOOO&E 101:389 March, 2006.

Lee S-J, Jang K-H, Spangberg LSW, Kim E, Jung I-Y, Lee C-Y, Kum K-Y. Three-dimensional visualization of a mandibula first molar with three distal roots using computer-aided rapid prototyping. OOOO&E 101:668. May, 2006.

Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura H. Effectiveness of dental computed tomography in diagnostic imaging of periapical lesion  of each root of a multirooted tooth: a case report. J Endod 32:583. June, 2006.

Radel RT, Goodell GG, McClanahan SB, Cohen ME. In vitro radiographic determination of distances from working length files to root ends comparing Kodak RVG 6000, Schick CDR, and Kodak Insight film. J Endod 32:566. June, 2006.

Nair MK, Nair UP. Digital and advanced imaging in endodontics: A review. J  Endod. 2007;33(1):1-6.

Carvalho FB, Gonçalves M, Tanomaru-Filho M. Evaluation fo chronic periapical lesions by digital subtraction radiography by using Adobe Photoshop CS: a technical report. J  Endod. 2007;33(4):493-7.

Chen C-H, Lin S-H, Chiu H-L, Lin Y-J, Chen Y-K, Lin L-M. An aiming device for an extraoral radiographic technique. J  Endod. 2007;33(6):758-60.

Huumonen S, Kvist T, Gröndahl K, Molander A. Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars. Int Endod J. 2007;39:827-33.

Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J  Endod. 2007;33(9):1121-32.

Rasimick BJ, Shah RP, Musikant BL, Deutsch AS. Radiopacity of endodontic materials on film and a digital sensor. J  Endod. 2007;33(9):1098-101.

Bianchi SD, Scoletta M, Cassione FB, Migliaretti G, Mozzati M. Computerized tomographic findings in bisphosphonate-associated osteonecrosis of the jaw in patients with cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(2):249-58.

Patel S, Dawood A, Ford TP, Whaites E. The potential applications fo cone beam computed tomography in the management of endodontic problems. Int Endod J. 2007;40:818-30.

Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of cone-beam computed tomography to identify root canal systems in vitro. J Endod. 2008;34(1):87-9.

Willershausen B, Kasaj A, Raab WH-M, Röhrig B, Marroquin BB. Radiographic investigation of frequency and location of root canal curvatures in human mandibular anterior incisors in vitro. J Endod. 2008;34(2):152-6.

Fan B, Gao Y, Fan W, Gutmann JL. Identification of a c-shaped canal system in mandibular second molars - part II: the effect of bone image superimposition and intraradicular contrast medium on radiograph interpretation. J Endod. 2008;34(2):160-5.

Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod. 2008;34(3):273-9.

Low KMT, Dula K, Bürgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008;34(5):557-62.

Hadley DL, Replogle KJ, Kirkam JC, Best AM. A comparison of five radiographic systems to D-spead film in the detection of artificial bone lesions. J Endod. 2008;34(9):1111-4.

Aggarwal V, Logani A, Shah N. The evaluation of computed tomography scans and ultrasounds in the differential diagnosis of periapical lesions. J  Endod. 2008;34(11):1312-5.

Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J  Endod. 2008;34(11):1325-31.

Miguens J, S.A.Q., Veeck EB, Fontanella VRC, da Costa NP. A comparison between panoramic digital and digitized images to detect simulated periapical lesions using radiographic subtraction. J  Endod. 2008;34(12):1500-3.

Bernier-Rodriguez JA, Sidow SJ, Joyce AP, McNally K, McPherson I, J.C. Radiographic interpretation of experimental lesions in radicular tooth structure of human maxillary anterior teeth. J  Endod. 2008;34(12):1466-9.

Katakami K, Mishima A, Shiozaki K, Shimoda S, Hamada Y, Kobayashi K. Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images. J  Endod. 2008;34(12):1441-5.

Liedke GS, da Silveira EE, da Silveira HLD, Dutra V, de Figueiredo JAP. Influence of voxel size in the diagnostic ability of cone geam tomography to evaluate simulated external reoot resorption. J  Endod. 2009;35(2):233-5.

Tu M-G, Huang H-L, Hsue S-S, Hsu J-T, Chen S-Y, Jou M-J, et al. Detection of permanent three-rooted mandibular first molars by cone-beam computed tomography imaging in Taiwanese individuals. J  Endod. 2009;35(4):503-7.

Moura MS, Guedes OA, De Alencar HG, Azevedo BC, Estrela C. Influence of length of root canal obturation on apical periodontitis detected by periapical radiography and cone beam computed tomography. J  Endod. 2009;35(6):805-9.

Simonton JD, Azevedo B, Schindler WG, Hargreaves KM. Age-and gender-related differences in the position of the inferior alveolar nerve by using cone beam computed tomography. J  Endod. 2009;35(7):944-9.