title: A comprehensive in vitro study of image accuracy and quality for periodontal diagnosis. Part 1: the influence of X-ray generator on periodontal measurements using conventional and digital receptors.
abstract: The aim of this study was the determination of image accuracy and quality for periodontal diagnosis using various X-ray generators with conventional and digital radiographs. Thirty-one in vitro periodontal defects were evaluated on intraoral conventional (E-, F/E-speed) and digital images (three indirect, two direct sensors). Standardised radiographs were made with an alternating current (AC), a high-frequency (HF) and a direct current (DC) X-ray unit at rising exposure times (20-160 ms with 20-ms interval) with a constant kV of 70. Three observers assessed bone levels for comparison to the gold standard. Lamina dura, contrast, trabecularisation, crater and furcation involvements were evaluated. Irrespective X-ray generator-type, measurement deviations increased at higher exposure times for solid-state, but decreased for photostimulable storage phosphor (PSP) systems. Accuracy for HF or DC was significantly higher than AC (p < 0.0001), especially at low exposure times. At 0.5- to 1-mm clinical deviation, 27-53% and 32-55% dose savings were demonstrated when using HF or DC generators compared to AC, but only for PSP. No savings were found for solid-state sensors, indicating their higher sensitivity. The use of digital sensors compared to film allowed 15-90% dose savings using the AC tube, whilst solid-state sensors allowed approximately 50% savings compared to PSP, depending on tube type and threshold level.. Accuracy of periodontal diagnosis increases when using HF or DC generators and/or digital receptors with adequate diagnostic information at lower exposure times.
authors.affiliation: Oral Imaging Centre, Faculty of Medicine, Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium. bart.vandenberghe@med.kuleuven.be
authors.forename: Bart
authors.initials: B
authors.lastname: Vandenberghe
authors.forename: Livia
authors.initials: L
authors.lastname: Corpas
authors.forename: Hilde
authors.initials: H
authors.lastname: Bosmans
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D000539:Alveolar Process / Q000000981:diagnostic imaging*; D002102:Cadaver; D017823:Furcation Defects / Q000000981:diagnostic imaging; D006801:Humans; D015588:Observer Variation; D010510:Periodontal Diseases / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods* / Q000592:standards; D016300:Radiography, Bitewing / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D019252:Radiography, Dental, Digital / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D013997:Time Factors; D014962:X-Ray Film; D014963:X-Ray Intensifying Screens