Digital intraoral radiographic quality assurance and control in private practice.

At present, the American Dental Association and the American Academy of Oral Maxillofacial Radiology have guidelines for the dental environment that include quality assurance and control of film-based radiography. Approximately 19%-30% of US dental offices currently use some form of digital intraoral radiography, and growth is expected to continue. It is anticipated that new tools and guidelines will be needed to aid in the development of quality assurance (QA) and control of digital intraoral radiographic images. Working with a representative sample of private practice dental offices, this study examined and evaluated the entire digital intraoral radiographic system used in each operatory. The X-ray machine was tested for equipment performance and accuracy, and the computer monitor calibration was evaluated and adjusted as needed. The results confirm the continued need for updated QA procedures in the dental office that include digital X-ray imaging. By implementing these changes and practices, dentists should be able to improve the diagnostic quality of radiographs while reducing the radiation exposure of the patient.

Effect of JPEG2000 compression on landmark identification of lateral cephalometric digital radiographs.

INTRODUCTION: As digital imaging improves and digital cephalometric radiography becomes more prevalent, the need for digital storage space and transmission speed will increase. Compression of the image files is 1 method to overcome transmission overload. However, compression could compromise image quality. The purpose of this study was to determine the range of compression ratios, by using the JPEG2000 standard, within which the identification of landmarks on cephalometric radiographs is not compromised. METHODS: Ten lateral cephalometric digital images were used. Six raters identified 19 landmarks under controlled viewing conditions. The images included the original uncompressed TIFF image and the JPEG2000 format at 3:1, 12:1, 50:1, and 110:1 compression ratios. The images were randomized and displayed with image processing software. The x and y coordinates of each landmark were recorded. RESULTS: All compression ratios performed equally well compared with the original images with the exception of A-point and nasion at 110:1 and gonion at 3:1 compression ratios. All landmark identifications were precise with the exception of the maxillary incisal apex and edge at the 12:1 and 50:1 compression ratios, respectively. CONCLUSIONS: JPEG2000 is a reliable file format that can be implemented in orthodontic practice.

Reporting of child abuse: a follow-up survey of Texas dentists.

PURPOSE: Child abuse is a disturbingly common finding in society today. There have been substantial and significant increases in the incidence of child abuse since the last national incidence study was conducted in 1986. Kassebaum first reported the under-reporting of child abuse by Texas dental professionals in a survey in 1986. The objective of the current study was twofold: (1) assess the level of knowledge and attitudes among dental professionals on the important issue of child abuse; (2) evaluate and compare the results of the current study with a similar survey conducted in 1986. METHODS: A 24-question survey similar in format and content to the 1986 questionnaire was mailed to 1,046 Texas dentists, randomly selected from a membership roster provided by the Texas Dental Association. Both general dentists and selected specialists were included in the study group. The questionnaire consisted of multiple-choice and dichotomous yes/no questions. RESULTS: There were 383 responses to the questionnaire, yielding a response rate of 38%. The majority (N=289) of the respondents were general dentists. In answering questions about suspected and reported cases of child abuse, nearly 50% of the responding dentists reported they had suspected at least 1 case of child abuse. In the 1986 study, only 36% of the responding dentists reported they had suspected at least 1 case of child abuse. Between 1986 and 2001, the survey has shown that the percentage of dentists who reported at least 1 case to authorities slightly increased from 19% in 1986 to 25% in 2001, but the ratio of suspected to reported cases had not changed since 1986. CONCLUSIONS: Although the composite percentage of suspecting and reporting cases of child abuse from this survey is higher than the percentage demonstrated in 1986 study, there was no significant change in the relative ratio of reported cases to suspected cases in both surveys. This indicates that under-reporting of child abuse cases is still a significant problem in the dental profession in Texas.

Quality assurance phantom for digital dental imaging.

OBJECTIVE: The purpose of this research was to develop a simple quality assurance phantom that could be used for the initial calibration and follow-up testing of commercially available intraoral digital imaging systems. STUDY DESIGN: A radiographic phantom was constructed that contains a calibrated step wedge for measuring dose response, an etched pattern of slits in a metallic background for measuring the spatial resolution in line pairs per millimeter, and 2 rows of wells of varying diameter and depth in an acrylic background for contrast-detail analysis. Quality assurance protocols were developed and validated. RESULTS: The quality assurance phantom provides a method of assessing a digital intraoral imaging system by measuring the sensitivity and dynamic range, the contrast/detail detectability and the spatial resolution. CONCLUSIONS: This quality assurance phantom can serve as an effective means to calibrate and monitor the performance characteristics of a digital dental intraoral imaging system.