Evaluation of common operator errors in panoramic radiography in Trinidad and Tobago: a comparison of formally vs informally trained operators / La evaluación de los errores comunes de los operadores de radiografía panorámica en Trinidad y Tobago comparación de los operadores adiestrados formalmente frente a los adiestrados informalmente

AIM: To evaluate and compare the frequency of common operator errors seen on panoramic radiographs in dental private practices and in the dental hospital (taken by informally and formally trained operators, respectively) in Trinidad and Tobago. METHOD: One thousand panoramic radiographs of patients over the age of 10 years were included in this study. These comprised 500 from the dental hospital and 500 from dental private practices. The radiographs were reviewed using standardized criteria to identify the most common operator errors. RESULTS: There were only 21 (4.2%) error free radiographs in the dental private practice sample and 29 (5.8%) in the dental hospital sample. Frequencies of specific errors were significantly higher in the dental private practice sample in each category except for "Chin tipped too low" (Chi-square p < 0.05) CONCLUSION: This study supports the need for the introduction of statutory guidelines with respect to the use of ionizing radiation in dentistry in Trinidad and Tobago and in particular, the implementation of formally assessed dedicated dental radiography training for all operators of dental X-ray equipment.

OBJETIVO: Evaluar y comparar la frecuencia de los errores comunes de los operadores, observados en las radiografías panorámicas en las clínicas dentales privadas y en el hospital de odontología (tomadas por operadores adiestrados formalmente e informalmente, de forma respectiva) en Trinidad y Tobago. MÉTODO: Mil radiografías panorámicas de pacientes de más de 10 años de edad, fueron incluidas en este estudio. Las mismas comprendían 500 provenientes del hospital odontológico y 500 provenían de las prácticas privadas de dentistas. Las radiografías fueron examinadas a partir de criterios estandarizados, a fin de identificar los errores más comunes de los operadores. RESULTADOS: Hubo sólo 21 (4.2%) radiografías sin errores en la muestra de la clínica dental privada, y 29 (5.8%) en la muestra del hospital de odontología. Las frecuencias de errores específicos fueron significativamente más altas en la muestra de la clínica dental privada en cada categoría, salvo el caso del "mentón inclinado excesivamente hacia abajo" (Chi-cuadrado p < 0.05) CONCLUSIÓN: Este estudio subraya la necesidad de introducir pautas reglamentarias con respecto al uso de la radiación ionizante en la cirugía dental en Trinidad y Tobago, particularmente en lo que concierne al adiestramiento especializado en radiografía dental, formalmente evaluado, para todos los operadores de equipos de rayos x para el trabajo dental.

Evaluation of common operator errors in panoramic radiography in Trinidad and Tobago: a comparison of formally vs informally trained operators.

AIM: To evaluate and compare the frequency of common operator errors seen on panoramic radiographs in dental private practices and in the dental hospital (taken by informally and formally trained operators, respectively) in Trinidad and Tobago. METHOD: One thousand panoramic radiographs of patients over the age of 10 years were included in this study. These comprised 500 from the dental hospital and 500 from dental private practices. The radiographs were reviewed using standardized criteria to identify the most common operator errors. RESULTS: There were only 21 (4.2%) error free radiographs in the dental private practice sample and 29 (5.80%) in the dental hospital sample. Frequencies of specific errors were significantly higher in the dental private practice sample in each category except for "Chin tipped too low" (Chi-square p < 0.05) CONCLUSION: This study supports the need for the introduction of statutory guidelines with respect to the use of ionizing radiation in dentistry in Trinidad and Tobago and in particular, the implementation of formally assessed dedicated dental radiography training for all operators of dental X-ray equipment.

Osteopetrosis--a review and report of two cases.

We present a brief review of the rare condition of osteopetrosis together with two case reports of this disease in the same family affecting the jaws. The first in a 41-year-old woman, and the second in her 39-year-old brother. Plain films and computed tomography showed marked sclerosis of the affected bones with obliteration of the medullary cavities and thickening of the cortices as well as multiple absent and unerupted teeth. In addition radiographs showed discrete mixed radiopaque/radiolucent areas consistent with the appearance of fibro-cemento-osseous dysplasia, but which may also represent part of the overall spectrum of bone changes in osteopetrosis.

Poland-Moebius syndrome: a case with oral anomalies.

The combination of Moebius and Poland anomalies is rarely described in the literature. While some authors believe this association is an independent syndrome, others think that Poland, Moebius and Poland-Moebius syndromes are variations of the same condition. We report a case of Poland-Moebius syndrome in a 6-year-old girl who presented with bilateral convergent strabismus, the inability to abduct her eyes beyond the midline and brachydactyly of her right hand. Oral manifestations included incompetent lips and an abnormal tongue. Other facial features included hypoplasia of her mandible and her left ear at a slightly lower level than her right ear. Panoramic and lateral skull radiographs confirmed the absence of certain teeth and the hypoplastic mandible. The diagnosis of Poland-Moebius syndrome was made on the basis of cranial nerve involvement and oro-facial manifestations.

Analysis of digital images acquired using different phosphor storage plates (PSPs) subjected to varying reading times and storage conditions.

OBJECTIVES: To assess, both objectively and subjectively, the effects of different combinations of storage conditions and varying delays in reading on digital images captured using phosphor storage plates (PSPs). METHOD: Standardized images were obtained of an aluminium step wedge and a dry mandible in acrylic using GE 1000 and PSPs from the Digora (Soredex) and DenOptix (Gendex) digital systems. Twelve plates from each system were exposed and immediately scanned to produce the baseline gold standard. The plates were re-exposed and stored using three different storage combinations, (A) ambient temperature, (R) refrigeration and (S) low humidity, and then scanned after 6 h, 12 h, 18 h, 24 h, 48 h or 72 h. Objective analysis was carried out by pixel density measurements and the data were analysed statistically using analysis of variance. Subjective analysis was carried by three oral radiologists and the results were analysed using Mann-Whitney U-test. RESULTS: For the DenOptix system there were no differences either objectively or subjectively in the images obtained from all the plates using different storage conditions and after varying time intervals. For Digora, objective analysis showed loss of pixel density after 6 h using all storage conditions. This loss of density was also evident subjectively after 6 h on plates stored under certain storage conditions. CONCLUSION: Storage of DenOptix PSPs for up to 72 h in different conditions does not affect the quality of the digital images. However, there is a loss of image density within 6 h when using Digora PSPs, which may affect clinical image interpretation.